The effects of the American Rescue Plan Act on racial equity in health insurance coverage

OBJECTIVE

To evaluate the effects on racial disparities in health insurance coverage from the changes in the Premium Tax Credit (PTC) implemented in March 2021 as part of the American Rescue Plan Act (ARPA).

DATA SOURCES AND STUDY SETTING

We use nationally representative individual-level data from the Household Pulse Survey (HPS), which provides demographic, economic, and health insurance information for United States residents during the period April 2020-August 2022.

STUDY DESIGN

While the PTC changes applied to all states, the 14 states that did not expand Medicaid received substantially more benefits than the expansion states since they had more uninsured individuals eligible for the PTC than the expansion states. In our analysis, the treatment (control) group includes all Medicaid nonexpansion (expansion) states. We use a difference-in-difference regression analysis to estimate the increase in the probability of insurance coverage after the expansion of the PTC. Furthermore, we conduct sensitivity and heterogeneity analyses.

DATA COLLECTION/EXTRACTION METHODS

We focus on survey respondents ages 18-64.

PRINCIPAL FINDINGS

The expanded PTC increased the probability of an individual having coverage through the Health Insurance Exchange (HIX) in a nonexpansion state by 0.95 (95% CI: 0.6136, 1.2900), 1.75 (95% CI: 1.1795, 2.3291), and 1.75 (95% CI: 1.1815, 2.3269) percentage points among White, Black, and Hispanic respondents, respectively. It also increased overall health insurance coverage among all groups.

CONCLUSIONS

The expanded PTC boosted HIX and overall health insurance coverage and reduced racial disparities.

The final piece of the Triangle of U: Evolution of the tetraploid Brassica carinata genome

Ethiopian mustard (Brassica carinata) is an ancient crop with remarkable stress resilience and a desirable seed fatty acid profile for biofuel uses. Brassica carinata is one of six Brassica species that share three major genomes from three diploid species (AA, BB, and CC) that spontaneously hybridized in a pairwise manner to form three allotetraploid species (AABB, AACC, and BBCC). Of the genomes of these species, that of B. carinata is the least understood. Here, we report a chromosome scale 1.31-Gbp genome assembly with 156.9-fold sequencing coverage for B. carinata, completing the reference genomes comprising the classic Triangle of U, a classical theory of the evolutionary relationships among these six species. Our assembly provides insights into the hybridization event that led to the current B. carinata genome and the genomic features that gave rise to the superior agronomic traits of B. carinata. Notably, we identified an expansion of transcription factor networks and agronomically important gene families. Completion of the Triangle of U comparative genomics platform has allowed us to examine the dynamics of polyploid evolution and the role of subgenome dominance in the domestication and continuing agronomic improvement of B. carinata and other Brassica species.