My goal is to produce academically rigorous and policy-relevant knowledge to address crucial problems facing society. The overarching focus has been on the politics and policies surrounding health access issues. Within this theme, there are currently three major strands: health access for vulnerable populations, the impact of provider networks on health access, and school-based health access. In addition, I continue to pursue my interest in regulatory policymaking with increasing connections to my work on healthcare issues. Overall, my work has led to almost forty publications in leading journals across a number of disciplines.

 

My work on vulnerable populations is multifaceted and explores a wide range of policy issues in U.S. health policy and politics. I am the lead author for most of the projects and responsible for conceptual development, data collection and analysis, as well as drafting.

 

Initially, my research on vulnerable populations analyzed state-federal relations in shared governance programs. Specifically, I demonstrated the importance of prior policy developments and healthcare environments, in addition to partisanship, for the implementation of various components of the ACA including marketplaces and high-risk insurance pools. Related works placed the developments into a larger historical context. A recent publication focused on the interaction and unintended side-effects of national policy interventions on local governments, while yet another publication highlighted the role of intense policy demanders in shaping resistance to the ACA.

 

I have expanded my focus into the role of public opinion and how it shapes policies and politics of health access. One recently published project parsed apart public opinion on Medicaid work requirements and highlighted the important role of racial resentment. My research has also analyzed public perceptions of blame for the opioid epidemic, as well as which policies the public supports to combat it. This work again emphasized the importance of racial resentment but also the role of personal connections. One of these projects was awarded the 2019 Leonard S. Robins Award. Current work focuses on how state descriptions of Medicaid and its beneficiaries, filtered through lenses of partisanship and racial resentment, affect attitudes towards Medicaid, beneficiaries, and broader policy. A related project specifically explores the role of Medicaid demographics in this regard. Other work analyzes how public opinion, including perceptions of deservingness and earned benefits, shapes administrative burdens, and the effect of them on health access.

 

I am further expanding this part of my portfolio with work assessing policy feedback processes, with an emphasis on how experience with public programs provided through private entities affect citizens. One project, funded by the McCourtney Institute, looks at how experiences with Medicare Advantage affect seniors’ perceptions of government, political engagement, and political behavior. Another assesses how experience with the VHA shapes public opinion on privatization. Finally, I recently completed the initial work on the politics of organ donation, focused on how to improve the organ transplant system.

 

A second strand of my agenda has focused on provider networks, which serve as pathway between insurance coverage and health access. This work has focused on diverse markets, medical specialties, and geographies. I am the lead or sole authors and have developed and implemented the research from conceptualization to data collection to data analysis and to drafting. I have led the integration of geospatial and provider quality information. I have also utilized my expertise on regulatory policymaking to study the effectiveness of current regulatory approaches and measurement. The body of my work has repeatedly highlighted regulatory shortcomings and implications for access. Novel data sets will allow unprecedented analyses of network adequacy regulations, consumer responses to inadequate networks, and grievances mechanisms. I am also at the forefront of assessing how problems with provider networks affect consumers’ financial and physical well-being. A recently accepted paper showed how Americans’ knowledge of and experience with surprise medical bills, a side effect of provider network issues, shape support for federal policy action. My most recent R01 submission scored just below the funding cut-off, but we were encouraged to reapply.

 

A third strand of my agenda, which has been partially funded by three grants from RWJF, addresses school-based health access, a crucial tool toward health equity, with an initial focus on school-based health centers in rural Appalachia, a region confronting countless health and access challenges while being home to a disproportionate number of SBHCs. I am currently using a combination of administrative data, surveys, and stakeholder interviews to assess the effect of SBHCs on health, emotional, and academic outcomes. Other work explores how local political and healthcare environments shape the emergence and sustainability of SBHCs. Most recently, I have expanded my work. This includes the role of partisanship for perceptions of vaccination mandates in educational settings and what role SBHCs can play in the health of vulnerable children during and post-COVID. My current work also begins to explore how underlying political and ideological conflicts affect school-based healthcare in general but particularly as related to vaccines and reproductive health. I am the lead or sole authors on all the projects.

 

Finally, I continue to work on several projects exploring the politics of regulatory policymaking. The work is the results of a full partnership with my long-time collaborator Dr. Susan Yackee, with joint conceptual development, data collection, and drafting, with primary responsibility for data analysis. My research was the first to empirically assess the influence of presidents on regulatory outcomes, and the role that interest groups and ideological misalignment play. Recent work also significant adds to the delegation literature by analyzing how small nuances in Congressional wording have significant implications for the rulemaking process. More recently, I concluded the first systematic assessment of the regulatory enterprise triggered by the ACA, highlighting the continued evolution of the law without statutory adjustments. Moreover, other recent work provided the first introduction of the use of guidance documents to the health and policy literatures. I continue to work on several major projects in this vein including the regulatory implementation of the ACA, as well as assessments of public knowledge of and participation in the regulatory process.