Health Insurance Coverage for Farmworkers in California After the Introduction of the Affordable Care Act: A Mixed-methods Study.

BACKGROUND: Previous studies have found that health insurance coverage expanded for farmworkers from 2011-2012 to 2015-2016 due in part to the introduction of the Patient Protection and Affordable Care Act (ACA). This study examines the continued impact of the ACA on insurance coverage for farmworkers to 2018 and identifies barriers to further expansion. METHODS: A mixed-methods approach was utilized. Weighted statistical analyses were conducted on the National Agriculture Worker Survey (NAWS) data for 2011-2012, 2015-2016, and 2017-2018. Qualitative interviews conducted with agricultural employers, health care providers, and community-based organizations examined the impact of the ACA on health insurance coverage for farmworkers. RESULTS: Though health insurance coverage for farmworkers in California increased after the introduction of the ACA (from 37.3% in 2011-2012 to 56.5%% in 2015-2016), coverage rates grew only modestly between 2015-2016 and 2017-2018 (64.8%). Coverage rates were higher for documented (43.0% in 2011-2012 and 77.7% in 2017-2018) than for undocumented workers (26% in 2011-2012 and 46.8% in 2017-2018). The results from the qualitative interviews suggested that barriers to increased coverage include the high cost of insurance for growers, high deductibles and copays for farmworkers, and distrust of government agencies. CONCLUSIONS: While the period after the ACA was associated with notable improvements in health insurance coverage for farmworkers in California, important barriers remain for farmworkers seeking to obtain insurance and for growers seeking to provide coverage. POLICY IMPLICATIONS: States should consider funding a farmworker-specific Medicaid program to provide health insurance coverage and care coordination across counties and states.

Appreciation, use, and management of biodiversity and ecosystem services in California's working landscapes.

"Working landscapes" is the concept of fostering effective ecosystem stewardship and conservation through active human presence and management and integrating livestock, crop, and timber production with the provision of a broad range of ecosystem services at the landscape scale. Based on a statewide survey of private landowners of "working" forests and rangelands in California, we investigated whether owners who are engaged in commercial livestock or timber production appreciate and manage biodiversity and ecosystem services on their land in different ways than purely residential owners. Both specific uses and management practices, as well as underlying attitudes and motivations toward biodiversity and ecosystem services, were assessed. Correlation analysis showed one bundle of ecosystem goods and services (e.g., livestock, timber, crops, and housing) that is supported by some landowners at the community level. Another closely correlated bundle of biodiversity and ecosystem services includes recreation, hunting/fishing, wildlife habitat, and fire prevention. Producers were more likely to ally with the first bundle and residential owners with the second. The survey further confirmed that cultural ecosystem services and quality-of-life aspects are among the primary amenities that motivate forest and rangeland ownership regardless of ownership type. To live near natural beauty was the most important motive for both landowner groups. Producers were much more active in management for habitat improvement and other environmental goals than residential owners. As the number of production-oriented owners decreases, developing strategies for encouraging environment-positive management by all types of landowners is crucial.

Consider the source: the impact of media and authority in outreach to private forest and rangeland owners.

Over half of the United States is privately owned. Improving environmental sustainability requires that the scientific and management communities provide effective outreach to the many landowners making decisions about land use and management practices on these lands. We surveyed California forest and rangeland owners in ten counties throughout the state to assess the impact of existing outreach and identify gaps in information distribution and content. Although a number of organizations provide land management advice highly-ranked by landowners, no individual organization currently reaches more than 30% of forest and rangeland owners, and these groups together reach less than 60% of landowners. The lowest ranked advice came from wildlife and land management agencies, whereas the highest ranked advice came from private consultants and advisory organizations. The ecosystem services provided by forests and rangelands are strongly influenced by conservation scale, and this appears to be recognized in current outreach efforts. Owners of large properties (>200 ha) were substantially more likely to have received land management advice than smaller-sized properties, and from a broader group of organizations. As ownerships become increasingly fragmented, outreach focus and methods will need to shift to more effectively target the owners of smaller properties. On the other hand, some major outreach goals, such as conservation of wildlife, ranchland, or agricultural communities, will continue to rely on effective outreach to owners of larger properties.