Federal Policymakers Research Articles

A qualitative comparison of parents’ experiences of early childhood expulsion following a legislative ban

Over the past decade, numerous reports have indicated pervasively high rates of early childhood expulsion nationwide. In response, state and federal policymakers have enacted various measures to ban or reduce reliance on such exclusionary discipline. Prior evaluations of the implementation of one such legislative ban on expulsion enacted in Illinois in 2018 showed partial reductions but relied only on program administrator-reported data. Parents (N = 16) of children (43.75% children of color) expelled from Illinois early childhood programs before and in the years since the 2018 legislative ban were interviewed about their experiences. Parents in both groups reported similar incidents regarding how and why children are excluded, how programs communicated with parents about children’s behavioral concerns, and how programs assisted (or did not) with accessing resources and supports that may enable a child to be retained. Findings indicate that expulsions continue to happen despite the ban and families’ experiences were essentially unchanged and negative. Findings hold implications for the implementation of similar policy efforts across the country.

Use of research evidence in U.S. federal policymaking: A reflexive report on intra-stage mixed methods

The policymaking process is largely opaque, especially regarding the actual writing of the policy. To attempt to better understand this complex process, we utilized mixed methods in our evaluation of an intervention. However, the process of mixing methods can be messy, and thus may require recalibration during the evaluation itself. Yet, in comparison to reporting results, relatively little attention is paid to the effects of mixing methods on the evaluation process. In this article, we take a reflexive approach to reporting a mixed methods evaluation of an intervention on the use of research evidence in U.S. federal policymaking. We focus on the research process in a qualitative coding team, and the effects of mixing methods on that process. Additionally, we report in general terms how to interpret multinomial logistic regressions, an underused analysis type applicable to many evaluations. Thus, this reflexive piece contributes (1) findings from evaluation of the intervention on the policymaking process, (2) an example of mixing methods leading to unexpected findings and future directions, (3) a report about the evaluation process itself, and (4) a tutorial for those new to multinomial logistic regressions.

Mental Health and U.S. Attitudes Toward Social Determinants of Health Policies

IntroductionResearch has suggested that individual health may influence policy attitudes, yet the relationship between mental health and policy support is understudied. Clarifying this relationship may help inform policies that can improve population mental health. To address this gap, this study measures national support for five social determinants of health policy priorities and their relation to mental health and political affiliation. MethodsThis study assessed support for five policy priorities related to the social determinants of health using a nationally representative survey of US adults (n = 2,430) conducted in March - April 2023. Logistic regression was used to estimate the predicted probability of identifying each priority as important, test differences in support by self-rated mental health, and evaluate whether partisanship modified these relationships. Analyses were conducted in 2023. ResultsThe majority of US adults, across partisan identities, supported five policy priorities related to improving the economy (84%), healthcare affordability (77%), improving K-12 education (76%), housing affordability (68%), and childcare affordability (61%). Worse mental health predicted significantly greater support for addressing housing affordability (73.9% vs. 66.2%), and partisanship modified the relationship between mental health and support for improving the economy, improving K-12 education, and housing affordability. ConclusionsIn 2023, there was substantial bipartisan support for federal policy action to address the social determinants of health, and worse mental health was related to greater policy support, particularly among Democrats. Federal policymakers have a broad consensus to take action to address the social determinants of health, which may improve population mental health.

Childcare disruptions and maternal health during the COVID-19 pandemic.

During the COVID-19 pandemic, nearly all US states enacted stay-at-home orders, upending usual childcare arrangements and providing a unique opportunity to study the association between childcare disruptions and maternal health. Using data from the 2021-2022 National Survey of Children's Health, we estimated the association between childcare disruptions due to the COVID-19 pandemic and self-reported mental and physical health among female parents of young children (ages 0-5 years). Further, we assessed racial, ethnic, and socioeconomic disparities in (1) the prevalence of childcare disruptions due to the COVID-19 pandemic and (2) the association between childcare disruptions and mental or physical health. Female parents who experienced childcare disruptions due to the COVID-19 pandemic were less likely to report excellent or very good mental (-7.4 percentage points) or physical (-2.5 percentage points) health. Further, childcare disruptions were more common among parents with greater socioeconomic privilege (ie, higher education, higher income), but may have been more detrimental to health among parents with less socioeconomic privilege (eg, lower education, lower income, and single parents). As state and federal policymakers take action to address the maternal health crisis in the United States, our findings suggest that measures to improve childcare stability may also promote maternal health and health equity.

Automating benefits delivery: lowering health insurance costs for unemployment insurance recipients.

To provide financial relief to those affected by the COVID-19 pandemic, from July to December 2021, the American Rescue Plan Act temporarily expanded eligibility for cost-sharing reduction (CSR) silver 94 plans that cover 94% of medical costs for unemployment insurance (UI) recipients enrolled in the Affordable Care Act (ACA) Marketplaces. In June 2021, California's ACA Marketplace automatically redetermined eligibility and enrollment for 79 645 UI recipients so the enhanced subsidies would be applied without any action required among program participants. Using administrative data from California and a difference-in-differences design, we found that enrollees automatically moved to CSR silver 94 plans for the second half of 2021 saved $295 in premiums and $180 in out-of-pocket expenses (or $475 in total). These findings can inform state and federal policymakers exploring ways of automating benefits delivery for consumers already engaging with other safety-net programs to increase health insurance affordability.

Integrating Health Policy Into Undergraduate Physiology: A Pedagogical Framework

Evidence-based health policies save lives. Rising to meet the global health challenges of the 21st century (e.g., the climate crisis, infectious diseases, health inequity) will require more scientists to participate in the policymaking process. However, few opportunities exist for STEM students to learn how their scientific knowledge can be applied to policy, or how they can shape the policies that govern science in the United States. Additionally, although scientific expertise is necessary to create effective health policies, it is not suffcient. For example, many scientifically sound policies (e.g., masking, vaccination) fail in the implementation phases because they are not communicated effectively to their intended audience. Here we share a pedagogical framework for integrating health policy into existing undergraduate physiology courses using examples from Anatomy and Physiology, Physiological Model Systems, and Public Communication of Physiology. This framework empowers students to develop procedural knowledge about state and federal policymaking, discuss examples of biomedical scientists and healthcare workers contributing to policy and rulemaking, link course curricula to current legislation proposed at the state or federal level, and advocate using their scientific knowledge and lived experiences as scientists. It also incorporates foundational science communication training that goes beyond the commonly used deficit framework (i.e., “educating the public”), and instead emphasizes dialogue (e.g., listening to stakeholders), rhetorical strategy (e.g., storytelling), trust-building, discrete goal setting, and positionality. Lastly, we provide preliminary evidence that using this health policy toolbox leads to student empowerment in policy and advocacy, development of practical communication skills applicable to their future careers, and deep affective connections to their physiology coursework. This project was supported by the Alan R. Bennett College of Liberal Arts and Sciences Public Health Policy Research Fund at the University of Connecticut. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Democratizing social scientists’ impact on federal policy: Using the evidence act to help government and ourselves

It is common for social scientists to discuss the implications of our research for policy. However, what actions can we take to inform policy in more immediate and impactful ways, regardless of our existing institutional affiliations or personal connections? Focusing on federal policy, I suggest that the answer requires understanding a basic coordination problem. On the government side, the Foundations of Evidence-based Policymaking Act (2018) requires that large federal agencies pose, communicate, and answer research questions related to their effects on people and communities. This advancement has opened the black box of federal agency policy priorities, but it has not addressed capacity challenges: These agencies often do not have the financial resources or staff to answer the research questions they pose. On the higher education side, we have more than 150,000 academic social scientists who are knowledge producers and educators by training and vocation. However, especially among those in disciplinary departments, or those without existing institutional or personal connections to federal agencies, we often feel locked out of federal policymaking processes. In this article, I define the coordination problem and offer concrete actions that the academic and federal government communities can take to address it. I also offer leading examples of how academics and universities are making public policy impact possible in multiple governmental spheres. I conclude by arguing that both higher education institutions and all levels of government can do more to help academic social scientists put our knowledge to work in service of the public good.

Toward a physical Dodge City high voltage direct current (HVDC) electricity hub

A physical Dodge City high voltage direct current (HVDC) electricity commodity hub would foster the kind of risk transfer that would invite the full participation of the financial industry in an interstate transmission system essential to the speedy development of renewable electricity and complementary storage technologies. Obstacles lie in the way of such a vision, however. Chief among them, paradoxically, is the administrative system that has evolved since the late 1990 s to promote regional electricity markets. That system abstracts from investment risk and the nation’s uneven geography of renewable resources. It lodges a kind of monopoly planning and scheduling power in a small group of bureaucratic centralized system operators that mimics a command economy in their own distinct regions, not the kind of market economy that has traditionally driven investment in US interstate energy infrastructure. And yet, in dealing with the vexing transmission constraints faced by the renewable generating sector (the “queue”), the Federal Energy Regulatory Commission (FERC) continues to pursue ever greater authority for those regional transmission organizations (RTOs). Such FERC action regarding its RTOs in 2022–23 represents a highly evident case of path dependency—a problem—that state or federal policy makers wishing to speed the entry of large-scale renewable generation, and complementary storage technologies, will have find a way either to confront directly or to work around.

Private Equity-Acquired Physician Practices And Market Penetration Increased Substantially, 2012-21.

Private equity (PE) firms have been acquiring physician practices at an increasing rate, raising concerns about such firms' penetration at the physician level into local markets and the impact on health care quality and prices. However, limited knowledge exists about the extent of PE firms' control in local markets. By linking data on PE acquisitions to physician data and using full-time-equivalent physicians as the base of assessment, we estimated the local market share of each PE firm within ten physician specialties at the Metropolitan Statistical Area (MSA) level. PE-acquired physician practice sites increased from 816 across 119 MSAs in 2012 to 5,779 across 307 MSAs in 2021. Single PE firms had significant market share, exceeding 30percent in 108 MSA specialty markets and exceeding 50percent in 50 of those markets. The findings raise concerns about competition and call for closer scrutiny by the Federal Trade Commission, state regulators, and policy makers.

Addressing Housing-Related Social Needs Through Medicaid: Lessons From North Carolina's Healthy Opportunities Pilots Program.

North Carolina Medicaid's Healthy Opportunities Pilots program is the country's first comprehensive program to evaluate the impact of paying community-based organizations to provide eligible Medicaid enrollees with an array of evidence-based services to address four domains of health-related social needs, one of which is housing. Using a mixed-methods approach, we mapped the distribution of severe housing problems and then examined the design and implementation of Healthy Opportunities Pilots housing services in the three program regions. Four cross-cutting implementation and policy themes emerged: accounting for variation in housing resources and needs to address housing insecurity, defining and pricing housing services in Medicaid, engaging diverse stakeholders across sectors to facilitate successful implementation, and developing sustainable financial models for delivery. The lessons learned and actionable insights can help inform the efforts of stakeholders elsewhere, particularly other state Medicaid programs, to design and implement cross-sectoral programs that address housing-related social needs by leveraging multiple policy-based resources. These lessons can also be useful for federal policy makers developing guidance on addressing housing-related needs in Medicaid.

Policies to address the Covid-19 pandemic: Lessons learned from tribal policymakers

Background: The Covid-19 pandemic created many challenges for federal policymakers. However, American Indian Tribal policymakers also had to rely on their treaty relationship the United States and set policies to protect their sovereign nations. The Covid-19 pandemic was devastating to tribal communities and amplified many inequalities these communities already face.Methodology: In this study, we interviewed Tribal policymakers using a phenomenological approach to examine tribal Covid-19 policies enacted and the governmental actions taken in response to the pandemic. Using a purposive sampling method, 11 interviews were included in the analysis.Discussion: These interviews represented 10 tribes across five culture areas. Ten themes were identified, including four related to issues to be addressed at the start of the pandemic and six associated with Covid-19 policy development and implementation. The findings from this study are intended to describe the ways in which some tribes operated within their infrastructures to keep their members safe.Conclusion: The Covid-19 virus had a devastating impact on American Indian communities. This study can aid in the generation of evidence-based information that can influence the development of policies regarding future outbreaks and pandemics.

Sustainable Tourism Development Index: A Scientifically Practical Proposal

Sustainable tourism development requires self-limitation and the delimitation on national or regional development, within the frame of Carrying Capacity (CC), while maximizing economic benefits evaluated in the Tourist Satellite Account (TSA). Sustainable Tourism should be determined by Carrying Capacity while Development level should be depicted on Tourism Satellite Account, at national or at local level. The research question of this study is to define where the “golden ratio” is located between sustainability and economic benefits maximization. Tourism experts and academics evaluated the sub-criteria, based on the Analytic Hierarchy Process (AHP), which form the Sustainable Tourism Index, within the framework of environmental protection, natural sources savings, eco-friendly practices, green investments, and of the highest contribution to GDP, to employment, to local income and to local and federal tax revenues. The results will support local and federal policy makers to design and apply tourism development ensuring sustainability.

Creating Systematic Structures to Support Student Success in Higher Education

This essay examines the importance of student success in higher education, particularly for underserved and disadvantaged student populations. This essay provides a review of contemporary trends in national postsecondary completion and strategies to enhance student success outcomes which will provide thriving economies and a talented workforce. Further, this work emphasizes the significance of approaching student success in a systematic way which engages campus leaders, state and federal policymakers, and workforce agencies.

Gap analysis of climate adaptation policymaking in Coastal Virginia

Due to its inherent multidimensionality and complexities, successful climate adaptation policymaking requires a concerted effort among multiple governance levels. Discovering the challenges and governance gaps can provide insights for policymakers paving the way for more effective policies in the future. This paper intends to provide such analysis for Coastal Virginia, a strategic region in the United States receiving significant climate impacts, particularly sea-level rise (SLR) and flooding. Utilizing semi-structured interviews with the main stakeholders and building on the adaptation framework of Moser and Ekstrom, we identify, categorize, and relate main adaptation challenges to better understand the gaps and underlying institutional dynamics causing them. Intergovernmental coordination and comprehensive planning and prioritization are the main overarching challenges, with high emphasis in the literature, while the challenge of retreat and the private sector are less discussed. It is followed by recommendations for different levels of government, informing the path forward from the stakeholders' perspective. A discussion of findings provides several implications for local, state, and federal policymakers. This research could be extended to other coastal and non-coastal areas to help formulate national and sub-national adaptation policies that maintain a holistic vision for adaptation policymaking while pondering the context-specificities of states, regions, and localities. It would be an essential task as adapting to climate change is still in its infancy stages, with the prospect of staying with us for decades to come.

Undoing a co‐operative bargain: The origins and dissolution of federal accommodation of provincial credit unions

AbstractThe failure of several U.S. regional banks early in 2023 underlined Canada's reputation as home to a resilient banking sector where federal policymakers guard their jurisdictional responsibility over banking against populist impulses and trade off competition for financial stability. This article argues that conventional explanations for this observed stability are incomplete because they omit any discussion of federal policies that shaped the growth of a $550 billion provincially based credit union system. This article reconciles the resulting puzzle by showing how policymakers accommodated credit unions and used them to channel populist impulses but within the bounds of over‐arching financial stability concerns.

Availability of off-marketplace plans with lower premiums for higher-income families.

Families with incomes above 400% of the federal poverty level were ineligible for marketplace premium tax credits before 2021 and may again be after 2025. Current laws temporarily removed this income cap, but because credits cap out-of-pocket premiums for a reference plan as a share of income, some higher-income families still receive zero tax credits. We quantified (1) premium differences between on- and off-marketplace plans and (2) the association between these premium differences and state decisions to finance cost-sharing reductions (CSRs) for lower-income families. We created a comprehensive database of on- and off-marketplace plans in each county (including both federal and state-based marketplaces). By county and metal level, we compared on- and off-marketplace (1) plan premiums in 2020 and (2) growth rates in the numbers of plans. We contrasted outcomes for states by how insurers were instructed to finance CSRs. In 2020, 89% of the US population lived in counties where some plans were offered exclusively off-marketplace. In these counties, for a 45-year-old choosing among silver plans in 2020 and who did not qualify for premium subsidies, premiums for the lowest-cost off-marketplace plans averaged 11.3% less than premiums for the lowest-cost on-marketplace plans. In contrast, for bronze and gold plans, the lowest-cost off-marketplace plans were, on average, more expensive. Silver plan premiums were 6.1% higher off-marketplace than on-marketplace in states that loaded CSRs on all silver plans, and 13.5% lower in states that loaded CSRs only on on-marketplace silver plans. Higher-income individuals and families may consider purchasing Affordable Care Act-compliant silver plans off-marketplace and thereby reduce their premiums. State and federal policy makers should consider the impact of their decisions on the choice between on- and off-marketplace plans.

The reintroduction of hemp in the USA: a content analysis of state and tribal hemp production plans

BackgroundThe reintroduction of Cannabis sativa L. in the form of hemp (< 0.3% THC by dry weight) into the US agricultural sector has been complex and remains confounded by its association with cannabis (> 0.3% THC by dry weight). This has been further exacerbated by inconsistent hemp regulations in the US since the 2014 Farm Bill’s reintroduction.MethodsA content analysis was performed to analyze the terms and definitions presented by state and tribal hemp production plans, the USDA Hemp producer license, and the 2014 state pilot plans. A total of 69 hemp production plans were analyzed.ResultsResults suggest significant discrepancies between hemp production plans, which have been exacerbated by extending the 2014 Farm Bill language into the 2018 Farm Bill timeframe.ConclusionsFindings from this study point to areas in need of uniformity and consistency as the regulatory framework is modified and provides a starting point for change for federal policymakers. The results may also be useful to companies attempting to market products across state boundaries. Suggestions for how to mitigate these inconsistencies are provided based on the content analysis findings.

A Good Crisis: Emergencies and the Reframing of American Higher Education, 1944–1965

ABSTRACT The purported “Golden Age” of American higher education, typically associated with the two decades following World War II, was marked by increasingly generous federal support of the nation’s postsecondary institutions and their students. Unlike analyses that attribute this largesse to factors like geopolitics (i.e., a response to the Cold War) or demographics (i.e., expansion to accommodate the Baby Boom generation), this article argues that a deliberate strategy rooted in rhetoric enabled “higher education partisans” to successfully push generous higher education policy in Washington, DC. Specifically, the language of crisis and emergency enabled these advocates to frame college-going as a tool that could solve social and economic problems, defend the nation and its values, and chip away at prejudice and inequality. Their success is evident in a “policy cascade” initiated by the 1944 GI Bill and reaching its apex with the 1965 Higher Education Act. This article relies on new archival research and document analysis to examine the trajectories of six key pieces of federal policymaking, which together constituted “a sheep in wolf’s clothing” by couching funding for colleges and universities as a response to urgent, even existential, crises.

Literacy, numeracy, and problem-solving skills of adults with disabilities in STEM fields

To aid in the development of a globally competitive workforce, federal policymakers have expressed the priority of preparing students and adults with disabilities to succeed in science, technology, engineering, and mathematics (STEM) fields. Yet, no research has examined the extent to which information-processing, literacy, numeracy, and problem-solving skills in technologically rich environments may associate with having a STEM degree for various disability populations. This study analyzed the United States nationally representative data from the Programme for the International Assessment of Adult Competencies (PIAAC) to examine associations between adult skills and having a STEM degree for people with and without disabilities. No direct associations were found between adult skills and having a STEM degree for people with learning disabilities or for people without disabilities. These groups’ information processing, literacy, numeracy, and problem-solving skills were not determining factors in STEM degree attainment. However, findings suggest a significant association between problem-solving skills and having a STEM degree for people with visual and/or hearing impairments. Policy implications are discussed.

Promoting the Mental Health of Parents and Children by Strengthening Medicaid Support for Home Visiting.

As state and federal policy makers seek to improve mental health, many aim to boost upstream approaches to prevent or mitigate diagnosable conditions. Home visiting offers a wholistic approach for new parents and children at home through health education, parenting support, and other services. Evidence of its benefits has accumulated across a growing number of home visiting models, some of which have demonstrated direct mental health outcomes, such as improved access to mental health services and reductions in family stress and maternal depression. Despite growing federal investments, home visiting reaches only a small fraction of families who might benefit. Public and private grant funding has successfully built and expanded home visiting in every state, but the current landscape of programs remains limited. As the nation's largest single coverage source for children, Medicaid, along with the Children's Health Insurance Program, has unsurpassed reach, to more than 40 million children and millions more families annually. Medicaid offers a natural vehicle to scale home visiting programs to promote early childhood development and address the mental health of both mothers and young children. To scale home visiting and reach far more families across the country who could benefit, federal policy makers should establish home visiting as a required Medicaid benefit and make additional investments to help states build capacity as the approach is scaled.