Uneven Impacts of Universal Policies related to Health and Economic Equity

Session Submission Type: Panel

Abstract

LGBTQ+ populations constitute a substantial and growing portion of the US population with unique health and economic circumstances across generations. This panel examine how ostensibly universal public policies yield uneven impacts on the health and economic outcomes of LGBTQ+ populations.

Paper 1 investigates how state-level Medicaid expansion impacts insurance coverage across sexual minority groups in early- to mid-adulthood. Using National Longitudinal Study of Adolescent to Adult Health (Add Health Waves 3-5) and a difference-in-difference design, Petry examines between- and within- group improvements in Medicaid coverage gains. As states’ Medicaid programs now face increasing uncertainty, Petry's paper offers evidence that reductions in Medicaid coverage are likely to disproportionately impact sexual minority groups with substantial effects on public health. Paper 2 examines the post-implementation period of federal Tobacco 21 (T21) legislation which raised the minimum legal sales age for tobacco products to 21. Using pooled Behavioral Risk Factor Surveillance System (2021–2023) data, Tran describes vaping and cigarette use among 18-20 years targeted by T21, as well sexual orientation-specific patterns of tobacco use and tobacco product preferences across different life stages. Findings challenge the notion that vaping products might serve as a harm reduction tool for some and a gateway product for other vulnerable populations. Paper 3 examines the role of the Earned Income Tax Credit (EITC) as a poverty reduction tool. In 2021 American Rescue Plan (ARP) included a temporary one-year expansion of the federal EITC for workers with no dependents. Using 30 waves of the U.S. Census Bureau’s Household Pulse Survey (July 2021-October 2023) and a difference-in-differences design, Kennedy examines differential impacts of the EITC on sexual and gender diverse (SGD) people’s financial security compared to non-SGD peers. As ARP funding wanes, new policy solutions to ensure financial security are needed.

Using data from a large cohort study, public health surveillance systems, and experimental federal data, this panel provides new evidence on how public policies can mitigate or exacerbate LGBTQ+ health and economic insecurity across all life stages.

 

Policy Area

• Health Policy

Secondary Policy Area

• Social Equity and Race

Chair

• Benjamin Jacob Harrell, Trinity College

Discussants

• Benjamin Jacob Harrell, Trinity College

• Hasan Shahid, University of Maryland, Baltimore County

Organizer

• Nathaniel M Tran, University of Illinois, Chicago

Individual Presentations

• Impact of Medicaid Expansion on Insurance Coverage for Sexual Minority Adults - Presenting Author: Sarah Petry, University of North Carolina at Chapel Hill

• Patterns of Vaping and Smoking by Sexual Orientation and Age Group after Tobacco 21 Implementation - Presenting Author: Nathaniel M Tran, University of Illinois, Chicago

• Effects of the Expanded EITC on Financial Security for Sexual and Gender Diverse Populations - Presenting Author: Katrina Kennedy, Johns Hopkins University

• The 2021 Child Tax Credit expansion and perinatal health - Presenting Author: Deborah Karasek, Oregon Health & Science University