The consequences of Medicaid expansion under the Affordable Care Act for police arrests.
The consequences of Medicaid expansion under the Affordable Care Act for police arrests.
复制标题
DOI：
10.1371/journal.pone.0261512
复制
发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Jahn JL
中科院分区：
文献类型：
--
作者：
Simes JT;Jahn JL
2020年夏季的全国性抗议活动引起了人们对警察在边缘化社区的大量存在的关注。最近的社会运动呼吁进行实质性的警察改革，包括“取消对警察的资助”，这一短语源于一个更大的历史性废除运动，主张将公共投资从刑事司法系统转向社会服务和医疗保健。虽然研究表明，警察在应对广泛的社会问题和卫生紧急情况方面发挥着广泛的作用，但现有的研究尚未充分探讨医疗保险政策影响人口逮捕率的能力。为了填补这一空白，我们研究了根据《平价医疗法案》（ACA）扩大医疗补助对美国3,035个县的逮捕的潜在影响。我们使用联邦调查局统一犯罪报告（UCR）计划数据比较了2014-2016年医疗补助计划扩展前后的县级逮捕情况，相对于非扩展州的县。我们使用差异中的差异（DID）模型来估计医疗补助扩大后逮捕的变化，包括整体逮捕，暴力，毒品和低级别逮捕。在ACA下的医疗补助扩大后，警方逮捕人数大幅下降。医疗补助的扩大在前三年的总逮捕率中产生了20-32%的负差异。我们观察到毒品逮捕的最大负差异：我们发现在医疗补助扩大后的三年内，与非扩大县相比，毒品逮捕的负差异为25-41%。我们观察到，在医疗补助扩大后的三年内，暴力逮捕率有19-29%的负差异，与非扩大县相比，扩大县的低级别逮捕率下降了24-28%。我们对毒品逮捕的主要结果对多个敏感性分析（包括州一级模型）是稳健的。本文中的证据表明，扩大医疗补助保险减少了警察逮捕，特别是与毒品有关的逮捕。再加上研究表明长期维持治安对弱势社区的健康造成有害后果，扩大保险覆盖范围为个人寻求护理、接受治疗和避免犯罪创造了新的途径。由于警察改革是在地方，州和联邦一级的议程上的高度，我们的论文支持的观点，广泛的卫生政策改革可以有意义地减少接触刑事司法系统的历史条件下的大规模犯罪。
National protests in the summer of 2020 drew attention to the significant presence of police in marginalized communities. Recent social movements have called for substantial police reforms, including “defunding the police,” a phrase originating from a larger, historical abolition movement advocating that public investments be redirected away from the criminal justice system and into social services and health care. Although research has demonstrated the expansive role of police to respond a broad range of social problems and health emergencies, existing research has yet to fully explore the capacity for health insurance policy to influence rates of arrest in the population. To fill this gap, we examine the potential effect of Medicaid expansion under the Affordable Care Act (ACA) on arrests in 3,035 U.S. counties. We compare county-level arrests using FBI Uniform Crime Reporting (UCR) Program Data before and after Medicaid expansion in 2014–2016, relative to counties in non-expansion states. We use difference-in-differences (DID) models to estimate the change in arrests following Medicaid expansion for overall arrests, and violent, drug, and low-level arrests. Police arrests significantly declined following the expansion of Medicaid under the ACA. Medicaid expansion produced a 20–32% negative difference in overall arrests rates in the first three years. We observe the largest negative differences for drug arrests: we find a 25–41% negative difference in drug arrests in the three years following Medicaid expansion, compared to non-expansion counties. We observe a 19–29% negative difference in arrests for violence in the three years after Medicaid expansion, and a decrease in low-level arrests between 24–28% in expansion counties compared to non-expansion counties. Our main results for drug arrests are robust to multiple sensitivity analyses, including a state-level model. Evidence in this paper suggests that expanded Medicaid insurance reduced police arrests, particularly drug-related arrests. Combined with research showing the harmful health consequences of chronic policing in disadvantaged communities, greater insurance coverage creates new avenues for individuals to seek care, receive treatment, and avoid criminalization. As police reform is high on the agenda at the local, state, and federal level, our paper supports the perspective that broad health policy reforms can meaningfully reduce contact with the criminal justice system under historic conditions of mass criminalization.
登录
查看更多内容
影响因子：
3.8
作者：
Courtemanche, Charles;Marton, James;Zapata, Daniela
通讯作者：
Zapata, Daniela
DOI：
10.7758/rsf.2020.6.2.08
发表时间：
2020-07-01
影响因子：
3.8
作者：
Courtemancheo, Charles;Martono, James;Yelowitz, Aaron
通讯作者：
Yelowitz, Aaron
影响因子：
3.4
作者：
Ettner, SL;Huang, D;Hser, YI
通讯作者：
Hser, YI
影响因子：
9.1
作者：
Brayne, Sarah
通讯作者：
Brayne, Sarah
影响因子：
9.7
作者：
Creedon, Timothy B.;Le Cook, Benjamin
通讯作者：
Le Cook, Benjamin