- Elaine Hernandez
- David Craig
- Ivan Hicks
Research Project Description
Health care access is pivotal to achieving health equity, particularly during the COVID pandemic. Administrative burdens—the learning, compliance, and psychological costs associated with determining eligibility, completing documentation, and stress/stigma from engaging with government programs—add hurdles for people attempting to enroll and maintain enrollment in Medicaid. During the COVID public health emergency, the federal government provided more funding to states that used protocols allowing beneficiaries to maintain continuous coverage. For example, Indiana removed the requirement for beneficiaries to prove eligibility annually and contribute financially to participate in Indiana's Medicaid expansion plan, leading to a 75% increase in enrollment by early 2022 (1 in 9 Hoosiers).
These changes offer a natural experiment and a rare window to inform policy to improve racial and ethnic equity in health care access. Structural racism permeates our health care systems. We focus on whether and how Medicaid administrative burdens create and/or reinforce discriminatory practices and racial inequities when Black & Latinx beneficiaries seek Medicaid coverage. Our objective is to examine whether reducing administrative burdens within Medicaid narrows racial/ethnic inequities in health care access.
We ask two questions. First, do Medicaid administrative burdens represent racialized burdens? Second, does eliminating or reintroducing Medicaid administrative burdens change racial and ethnic inequities in health care access? Building on established partnerships between the university and community, we will pair (1) in-depth semi-structured interviews with a randomly selected sample of Medicaid beneficiaries across Indiana with (2) analyses of Medicaid enrollment and utilization data. Together, we will develop strategies to make it easier to enroll in and utilize Medicaid and disseminate our research findings to inform decisions about health policy and Medicaid protocol.
A sociologist with training in public health administration & policy and health demography, Dr. Hernandez brings substantive and methodological breadth. She uses theoretical perspectives from medical sociology combined with research on health demography, health policy, and biology. She has consistently engaged in interdisciplinary work-for the Indiana State Health Department and at the local level-both in and outside of academia.
An ethicist, Dr. Craig developed health policy expertise through a qualitative interview study with hospital leaders and interfaith activists about the organization and reform of US health care. He used his skills as a moral ethnographer to engage HIP Medicaid members' lived experiences and problem-solving of its barriers. For two years, he has co-led community health collaborations among Black and multiracial congregations.
Dr. Hicks is an ethnographer with a Ph.D. in African American Studies as opposed to the D.Min, the professional doctorate in his field, in order to not just grasp the science of politics and master theological studies, but to diversify his academic portfolio by attaining a different type of degree. He challenges students to produce not only action research based projects and dissertations, but to pursue scholarship that can easily be categorized as scholar activism.