The Affordable Care Act has reportedly helped to bring increased rates of insurance to low-income populations and provide more affordable insurance options to those struggling to afford it. Primarily, this is achieved through funding state programs to support the health of low-income communities, expanding pre-existing Medicaid eligibility to give more direct federal aid to low-income families, and through availing those ineligible for Medicaid with discounted rates for private health insurance through the healthcare exchanges. However, state responses to the funding received from the ACA differ drastically, leading to inconsistent outcomes. Moreover, literature suggests this population is still underinsured and that health outcomes continue to suffer. Using the National Health Interview Survey from years 2015-2019, this paper attempts to correlate the various types of insurance to various indicators of primary health. These include incidences of chronic illness and access to primary healthcare, as lower indices are generally indicative of poor and worsening health outcomes over time. Primarily analyzed in this paper are the differences in health outcomes between populations that are covered under private health insurance, Medicaid, and marketplace-based (exchange) insurance. In doing so, this paper aims to assess the state of the Medicaid program and the average efficiency of exchange based plans across the United States in promoting the general wellness of such populations.
Sustainability is a concept that is thrown around often in the modern era without much specificity on what can be done to truly achieve this goal. This is especially the case in developed nations like the United States, who in many ways disproportionately contribute to the overall problem of climate change on a global level. In an increasingly urbanized world, urban population centers present complicated relationships between human beings and the environment that affect millions of people on a daily basis. This paper examines the relationship between cities and climate change by analyzing the impact of sustainability programs that have been enacted in the New York City and Houston metropolitan regions. Using these two urban centers as case studies, sustainability is assessed in both its holistic success and the level of equity in outcomes produced from these programs and their impact on people. Not only do both of these cities have significant history with climate disasters and the worst effects of the climate crisis, but also have made significant efforts to improve not only their resiliency for present day environmental situations, but also the future that climate issues have provided us. This paper provides a qualitative analysis of these programs in order to extrapolate knowledge that can not only significantly change how urban citizens interact with the greater environment, but also help us understand how to make future sustainability projects be more equitable in providing for citizens throughout a cities’ population no matter their characteristics.