The Effect of Work Requirements in SNAP in Virginia
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Work requirement exemption months.
- Кому может быть актуально
- Состояния в реестре: Health Disparities, Food Security. Базовые параметры: 18 лет — 49 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- США
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Disparities in Medicaid and SNAP Participation: the Effects of Work Requirements and the COVID-19 Pandemic
Обзор
More than a dozen states have proposed or plan to implement work requirements in Medicaid, and similar requirements already exist nationally in the Supplemental Nutritional Assistance Program (SNAP), yet evidence on the effects of these policies is limited. In cooperation with the state of Virginia, the investigators plan to conduct a randomized controlled trial studying the impacts of work requirements in public programs on insurance coverage, SNAP participation, employment, and health, with a particular focus on changes in racial/ethnic and geographic disparities in these outcomes. The COVID-19 epidemic and concurrent economic downturn creates additional urgency around these issues, and the investigators will use a combination of national administrative data and a new population survey to assess disparities in employment, health care, and food insecurity during this crisis.
Подробное описание
Work requirements are becoming increasingly common in major public assistance programs, with federal requirements for most adults to work in order to participate in the Supplemental Nutritional Assistance Program (SNAP, previously known as food stamps), and more than a dozen states proposing similar requirements in Medicaid. Proponents of work requirements contend that these policies increase beneficiary engagement in work and community activities that may lead to higher incomes and better health. On the other hand, opponents of work requirements suggest that many low-resource households will lose much-needed benefits, without commensurate improvements in employment. The investigators propose a randomized controlled trial of work requirements in Virginia, leveraging state support for exempting a portion of Medicaid expansion enrollees from the state's proposed work requirements. The investigators are also working with the state to explore the impact of work requirements in SNAP. They will study the impacts of each policy on health insurance coverage, access to care, employment, food insecurity, and health outcomes using a mix of administrative data and a new beneficiary survey. Our analysis will oversample several populations of interest, including racial/ethnic minorities and low-income rural residents. In doing so, investigators will identify the overall policy impacts of these policies, and will also assess who is most affected by each component to determine the impact of these policy changes on racial, ethnic, socioeconomic, and geographic disparities. Meanwhile, the COVID-19 epidemic and concurrent economic downturn create additional urgency around the issues of employment and participation in social programs. Using a combination of national administrative data and a new population survey, this study will also provide a timely assessment of disparities in employment, health care, and food insecurity during the current public health and economic crises.
Вмешательства
- Другое Work requirement exemption months
Cross-randomized intervention will test effect of additional exemption months before work requirements in SNAP become binding and extensions of the standard SNAP recertification period.
Первичные конечные точки
- SNAP enrollment [Срок оценки: Up to 24 months after randomization]
- Employment status [Срок оценки: Up to 24 months after randomization]
- UI covered earnings [Срок оценки: Up to 24 months after randomization]
- Non-UI covered earnings [Срок оценки: Up to 24 months after randomization]
Вторичные конечные точки (12)
- Number of jobs held [Срок оценки: Up to 24 months after randomization]
- Medicaid participation [Срок оценки: Up to 24 months after randomization]
- Hospitalizations [Срок оценки: Up to 24 months after randomization]
- Credit scores [Срок оценки: Up to 24 months after randomization]
- Evictions [Срок оценки: Up to 24 months after randomization]
- Crime (records of charges, convictions) [Срок оценки: Up to 24 months after randomization]
- Food insecurity [Срок оценки: Survey to be administered approximately 1 year after randomization begins]
- Self-reported health [Срок оценки: Survey to be administered approximately 1 year after randomization begins]
- Depression score [Срок оценки: Survey to be administered approximately 1 year after randomization begins]
- Non-work community engagement activities [Срок оценки: Survey to be administered approximately 1 year after randomization begins]
- Forced moves, housing instability [Срок оценки: Survey to be administered approximately 1 year after randomization begins]
- Reasons for exiting SNAP [Срок оценки: Survey to be administered approximately 1 year after randomization begins]
Критерии участия
Критерии включения
- Eligible for Virginia's SNAP program as an "able-bodied adult without dependents" (ABAWD) and thus subject to work requirements (this eligibility is age restricted to 18-49)
Критерии исключения
- Categorical exemption from work requirements for any reason (e.g., has a disability, has dependents, resides in a geographic area where work requirements have been waived due to elevated employment)
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Да
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Факторный дизайн
- Маскирование
- Открытое
- Основная цель
- Организация здравоохранения
Центры проведения
США · 1 центр
- Virginia Department of Social Services (Home Office) — Glen Allen
Идентификаторы
NCT: NCT04888832 · IRB19-0859 · 5R01MD014970-02