Publications by authors named "Aparna Soni"

Overdose deaths from prescription opioids remain elevated, and policymakers seek solutions to curb opioid misuse. Recent proposals call for price-based solutions, such as opioid taxes and removal of opioids from insurance formularies. However, there is limited evidence on how opioid consumption responds to price stimuli.

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Rates of neonatal abstinence syndrome (NAS) resulting from opioid misuse are rising. However, policies to treat opioid misuse during pregnancy are unclear. We apply a difference-in-differences design to national pediatric discharge records to examine the effects of state Medicaid policies on NAS.

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Objectives: To assess changes in young parents' health behaviors following implementation of New York State's Paid Family Leave Program (NYSPFL).

Methods: We used synthetic control (N = 117,552) and difference-in-differences (N = 18,973) models with data from the nationally representative Behavioral Risk Factor Surveillance System (BRFSS) from 2011 to 2019 to provide individual-level estimates of the effects of NYSPFL on self-reported exercise in the past month and average daily sleep of adults aged 21-30 years living with one or more children under 18 years of age in New York and comparison states.

Results: Synthetic control model results indicate that the NYSPFL increased the likelihood of exercise in the past month among mothers, single parents, and low-income parents by 6.

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Objective: To assess post-COVID-19 changes in insurance coverage, health behaviors, and self-assessed health among low-income, non-elderly adults by state Medicaid expansion status.

Data Sources: We used nationally representative survey data from the 2016 through 2020 Behavioral Risk Factor Surveillance System (BRFSS). The sample was restricted to adults aged 19-64 with household income below 138 percent of the federal poverty level (N = 179,135).

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The federal individual mandate of the Affordable Care Act, which required people to pay a tax penalty if they did not have health insurance, was repealed in 2019. However, some states implemented state-level insurance mandates which essentially replaced the federal mandate. I use nationally representative survey data from the 2015-19 Annual Social and Economic Supplement to the Current Population Survey to compare the probability of becoming newly uninsured among people living in states without state-level insurance mandates versus states with a mandate, before and after the 2019 repeal.

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Introduction: Health insurance expansions may increase early detection of cancer and reduce late-stage cancer incidence. The study assesses the effects of the Affordable Care Act Medicaid expansions on rates of early- and late-stage cancer diagnosis up to 3 years after implementation.

Methods: Population-based quasi-experimental analysis of nonelderly adults was conducted in 732 counties from the 2010-2016 Surveillance, Epidemiology, and End Results Program cancer registry data.

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This study examines the longer term relationship between public health insurance expansions and health behaviors. I leverage geographic and temporal variation in the implementation of the Affordable Care Act-facilitated Medicaid expansions and provide the first estimates of the expansions' behavioral impacts during their first 5 years. Using national survey data from the 2010 to 2018 Behavioral Risk Factors Surveillance System and a difference-in-differences regression design, I show that the Medicaid expansions increase utilization of certain forms of preventive care, while reducing heavy drinking.

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Context: Twenty states are pursuing community engagement requirements ("work requirements") in Medicaid, though legal challenges are ongoing. While most nondisabled low-income individuals work, it is less clear how many engage in the required number of hours of qualifying community engagement activities and what heterogeneity may exist by race/ethnicity, age, and gender. The authors' objective was to estimate current levels of employment and other community engagement activities among potential Medicaid beneficiaries.

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Importance: The rate of opioid-related emergency department (ED) visits and inpatient hospitalizations has increased rapidly in recent years. Medicaid expansions have the potential to reduce overall opioid-related hospital events by improving access to outpatient treatment for opioid use disorder.

Objective: To examine the association between Medicaid expansions and rates of opioid-related ED visits and inpatient hospitalizations.

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A growing body of literature examining the effects of the Affordable Care Act (ACA) on nonelderly adults provides promising evidence of improvements in health outcomes through insurance expansions. Our review of forty-three studies that employed a quasi-experimental research design found encouraging evidence of improvements in health status, chronic disease, maternal and neonatal health, and mortality, with some findings corroborated by multiple studies. Some studies further suggested that the beneficial effects have grown over time and thus may continue to grow if the ACA insurance expansions remain in force.

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Candida yeast species are widespread opportunistic microbes and incidence of its carriage in diabetic patients compared with non-diabetic controls is not clearly defined. The present study was carried out to isolate and identify the candida species in type I, type II diabetes mellitus patients and in controls. Study comprised of 60 subjects in the age range of 20 to 65 years, consisting of two groups of diabetes patients with controlled diabetic status (20 subjects each with type I and type II) and 20 age and sex matched controls.

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Little is known about how the Affordable Care Act might have differentially affected insurance coverage for self-employed workers, wage earners with and without offers of employer-sponsored insurance, and people not employed. We found that the self-employed and wage earners without employer coverage offers had coverage gains equal to or greater than those of people not employed.

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Background: The Affordable Care Act (ACA) of 2010 incentivized states to expand eligibility for their Medicaid programs. Many did so in 2014, and there has been great interest in understanding the effects of these expansions on access to health care, health care utilization, and population health.

Objective: To estimate the longer-term (three-year) impact of Medicaid expansions on insurance coverage, access to care, preventive care, self-assessed health, and risky health behaviors.

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Objectives: To determine whether the 2014 Medicaid expansions facilitated by the Affordable Care Act affected overall and early-stage cancer diagnosis for nonelderly adults.

Methods: We used Surveillance, Epidemiology, and End Results Cancer Registry data from 2010 through 2014 to estimate a difference-in-differences model of cancer diagnosis rates, both overall and by stage, comparing changes in county-level diagnosis rates in US states that expanded Medicaid in 2014 with those that did not expand Medicaid.

Results: Among the 611 counties in this study, Medicaid expansion was associated with an increase in overall cancer diagnoses of 13.

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This analysis uses SEER Medicaid data to quantify changes in health insurance coverage under the Affordable Care Act among nonelderly patients newly diagnosed with cancer.

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The Affordable Care Act made low-income nonelderly adults eligible for Medicaid in 2014 without requiring them to obtain disabled status through the Supplemental Security Income (SSI) program. In states that participated in the Medicaid expansion, we found that SSI participation decreased by about 3 percent after 2014.

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The U.S. population receives suboptimal levels of preventive care and has a high prevalence of risky health behaviors.

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Purpose: To analyze the differential rural-urban impacts of the Affordable Care Act Medicaid expansion on low-income childless adults' health insurance coverage.

Methods: Using data from the American Community Survey years 2011-2015, we conducted a difference-in-differences regression analysis to test for changes in the probability of low-income childless adults having insurance in states that expanded Medicaid versus states that did not expand, in rural versus urban areas. Analyses employed survey weights, adjusted for covariates, and included a set of falsification tests as well as sensitivity analyses.

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Malignancy is considered as a pathological imbalance of tissue-cell societies, a state that emerges from tumor-host microenvironment in which host participates in induction, selection and expansion of the neoplastic cells. Invasion of these malignancies can be viewed as a derangement in the proper sorting of cell populations, causing a violation of normal tissue boundaries. This violation is carried out by certain stromal cells like carcinoma associated fibroblasts (CAFs), tumor associated macrophage (TAMs), endothelial cells (ECs) leucocytes, bone marrow derived cells, etc.

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