Expanding Health-Care Access in the United States: Gender and the Patchwork 'Universalism' of the Affordable Care Act

This paper focuses on the ways in which women in the United States are impacted by the 2010 passage of the Patient Protection and Affordable Care Act (usually referred to as ACA or 'Obamacare'). The ACA's three main goals of expanding access, increasing consumer protections and reducing costs while increasing quality of services will improve coverage, access to services and types of services that benefit women (and men). However, universal coverage remains illusive due to employer-based insurance coverage that allows firms to make decisions about coverage type. This patchwork universalism is the result of political decisions to extend rather than transform the current health-care system and as such reproduces many of the previously existing problems of uneven costs and coverage. The paper argues the ACA is consistent with other sets of US social welfare and labour market regimes that stratify access to social protections by income, race/ethnicity and gender as well as provide individual states with administrative and policy authority. The paper concludes that the passage of ACA will vastly improve health-care coverage in the United States, however, will continue to leave millions of people uninsured. This paper was produced for UN Women's flagship report Progress of the World's Women 2015-2016 and is released as part of the UN Women discussion paper series

An Economic Profile of Women in Massachusetts

This report provides a profile of women\u27s current economic position in Massachusetts. It examines the age, race, and geographical distribution of women and girls across the state; family structure, income and poverty; and women\u27s labor force participation, occupational and industrial distribution in jobs, and earnings. When relevant 1990s Massachusetts data are compared to national data and to Massachusetts data from the 1970s. Women across the Commonwealth have experienced tremendous changes in their lives over the last two decades as a result of changes in the economy and family structure. For women, the changes provide new opportunities, but they also exacerbate or even create new tensions between family and work life. One set of changes involves the relatively rapid restructuring of the Massachusetts economy away from manufacturing toward a more service-oriented economy operating under increased globalization opportunities and pressures. The other set of changes concerns the steady increase of women into the paid labor market and the varied composition of families and households. Women\u27s economic activities, both in the home and in the workplace, are still quite different from men\u27s. Women provide more unpaid labor at home than men, earn less from paid employment, and work in different jobs. The data presented here is intended to inform and facilitate discussion concerning our economic future

Low-Wage Workers Really Feel the Squeeze

In the United States, it has been generally assumed that those who held a steady job could make ends meet but in today’s labor market nothing could be further from the truth. Workers in low-wage jobs can face double jeopardy: insufficient income to cover their basic needs and lack of access to job-related benefits to supplement their earnings. Public work supports — programs to help families fill basic needs such as health care, child care, food, and housing — can fill the gaps, and for many, they do. Still, in Massachusetts close to one out of every four individuals in a family with earnings does not have enough to meet basic personal needs, even with public supports

Moving Target: The Dilemma of Serving Massachusetts Poor Families

While Community Action Agencies’ original mission of serving the poor has changed little over the last three decades, government commitments to the poor, the population of poor individuals and families, and women’s economic expectations have changed considerably. This article documents the trends in family structure, women’s employment patterns, and poverty policies in Massachusetts between 1970 and 2000. The increase in poor, single-mother families and poverty policies that emphasize employment present dynamic challenges for Community Action Agencies (and others who serve the poor), but also create some new organizing opportunities

Tax to Grind: Unequal Personal Income Taxation of Massachusetts Single-Parent Families and Options for Reform

While Massachusetts households headed by single parents have, on average, less income than other types of families, they are subject to the same effective income tax rate as the population as a whole. Consequently, such head-of-household families are victims of inequitable tax treatment in two ways. First, their current personal exemptions result in a higher tax burden on these families than on families of the same size and income who file joint income tax returns. Second, head-of-household families, defined as single filers, must apply a lower no-tax threshold than joint filers, even though the former are also composed of two or more persons. Both tax provisions translate to less tax relief for many low-income families than other low-income filers, yet they can easily be remedied at a relatively low cost to the commonwealth. This article presents data on the 1988 tax burdens of single, joint, and head-of-household filers and suggests three options for tax reform to correct these inequities

Why it’s Harder (and Different) for Single Mothers: Gender, Motherhood, Labor Markets and Public Work Supports

This paper focuses on low-wage work and single mothers. I begin with a typical example of early 20th century research on low-wage workers as it helps provides both an historical explanation for women’s earnings and employment situation over much of the 20th century and important insights into new directions for research and advocacy. Following that, I tease apart the distinctions between having low wages and being low income, particularly as these apply to single mothers. I then detail the resource base for single mothers which entails the complex relationship between family structure and obligations, earnings and employment benefits, and public supports. I argue that the three main current analytical approaches to single mothers’ resources are individually insufficient to tackle the new dilemmas facing single mothers with low earnings, but can be linked together to more fully illuminate these dilemmas. Finally, I offer three directions for research and advocacy

Bridging the Gaps Between Earnings and Basic Needs in Massachusetts

In the United States, it is generally assumed that people who hold a steady job are able to make ends meet. But, in today’s labor market, where nearly a quarter of jobs pay low wages and do not offer benefi ts such as health insurance and retirement plans, this could not be further from the truth for millions of workers and their families. In fact, most workers do not make ends meet on their wages alone. Even upper- and moderate-wage workers are not “self-suffi cient” in a literal sense, as most receive onthe-job benefi ts, such as employer-provided health insurance or paid sick days, and are eligible for unemployment or disability insurance if they need it

Double Jeopardy: Low-wage and Low-income Workers in Massachusetts, 1980–2009

Data reveal a growing number of Massachusetts workers who both earn low wages and live in low-income families. They face “double jeopardy”: As low-wage earners, they are least likely to receive employer-sponsored benefits, yet they are often ineligible for means-tested government anti-poverty programs

Combining Earnings with Public Supports: Cliff Effects in Massachusetts

Safety-net benefits decrease as recipients’ income increases, but the result can be an overall drop in resources—sometimes so sharp that it feels like falling off a cliff

Bridging the Gaps Between Earnings and Basic Needs in Massachusetts: Executive Summary and Final Report

In the United States, it is generally assumed that holding a steady job is enough to make ends meet. But, in today’s labor market, where nearly a quarter of jobs pay low wages and offer no benefits, this couldn’t be further from the truth for millions of workers and their families. Most workers do not make ends meet on their wages alone. Upper- and moderate-wage workers are not “selfsufficient” as most receive on-the-job benefits, such as employer-provided health insurance or paid sick days, and are eligible for unemployment or disability insurance if they need it. Workers in low-wage jobs find themselves with insufficient wages to cover their basic family needs and also do not typically have access to job-related benefits to supplement their earnings. Public work supports — programs to assist working families access basics, such as health care, child care, food, and housing — could fill in the gaps and for many, they do. But, many families who struggle to bridge their resource gaps find that they make too much to be eligible for work supports. One reason for this problem is that many of our work support programs were established to assist very low-income, non-working families or single parents with very low, but steady, earnings. These programs were not typically designed to serve working families with earnings above the official poverty threshold, even though low-wage workers are not typically offered employment-based benefits. Moreover, even those who are eligible often do not receive them. These problems are widespread and are particularly acute for families with children, as well as those with one adult earner