As the first study to describe DACA-eligible young adults' health needs, these data demonstrate their profound mental health challenges and numerous barriers to health care access. Many barriers were attributed to their undocumented status and persisted even when they gained temporary legal status. This work provides a foundation for evidence-based policy changes to address the health needs of this and other undocumented populations.
This paper evaluates the costs, benefits and related impacts of living wage policies implemented at the San Francisco Airport (SFO). Unlike other living wage ordinances, the policies at SFO cover a large proportion of the low-wage labor force in a distinct labor market. We find that about 73 percent of the ground-based non-managerial workers at SFO received substantial wage increases as a direct or indirect result of the policies; the proportion of these workers earning under $10 per hour fell from 55 percent to 5 percent, significantly reducing earnings inequality. Other benefits to workers included enhanced health benefits and an arrest of declines in quality of life indices. The costs of the policies to employers amounted to an average of 0.7 percent of revenue, or $1.42 per airline passenger. We observe a series of dynamic adjustments that reduced those costs, including dramatically reduced turnover, improved worker morale and greater work effort. We find some limited evidence of worker-worker substitution, but no evidence of employment decline.3
This article explores the creation, design, and execution of a university-based collaboration to provide responsive research and evidence to a group of diverse health care, labor, and consumer stakeholders through convening a funded series of deliberative meetings, research briefs, peer-reviewed journal articles, ad hoc data analyses, and policy analyses. Funded by the California Endowment, the California Health Policy Research Program was created by researchers at the University of California, Berkeley Center for Labor Research and Education, and the UCLA Center for Health Policy Research. The collaboration not only allowed new research and analyses to be used by stakeholders and policy makers in decision making but also allowed university researchers to receive input on the important health policy issues of the day. The guidance of stakeholders in the research and policy analysis process was vital in driving meaningful results during an important time in health policy making in California. The manuscript discusses lessons learned in building relationships with stakeholders; meeting research and analytic needs; engaging stakeholders and policy makers; building capacity for quick-turnaround data collection and analysis, dissemination and publication; and maintaining the collaboration.
Enrollment navigators and government-employed Medicaid workers were an important element in the Affordable Care Act's (ACA) initial enrollment success. The Centers for Medicare and Medicaid Services eliminated 41% of funding for 2017 navigator programs and 90% of funding for outreach, arguing less investment was needed. Given that many remain uninsured, it is critical to identify effective enrollment practices. This study characterizes barriers and enrollment strategies from the perspective of California's Medicaid government and community-based enrollment workers (n=101 in eight focus groups). Participants identified a need for communication with policymakers, the state exchange, and each other regarding changing enrollment processes. Solutions include increased contact between enrollment workers to share strategies and policy updates regarding application processing, uniform policy interpretation, and details of ACA-related immigration law. Given efforts to weaken the ACA, it is critical to engage frontline workers in problem solving to streamline enrollment strategies, particularly for vulnerable populations.
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