Welcome Mats and On‐Ramps for Older Adults: The Impact of the Affordable Care Act's Medicaid Expansions on Dual Enrollment in Medicare and Medicaid

For many low‐income Medicare beneficiaries, Medicaid provides important supplemental insurance that covers out‐of‐pocket costs and additional benefits. We examine whether Medicaid participation by low‐income adults age 65 and up increased as a result of Medicaid expansions to working‐age adults under the Affordable Care Act (ACA). Previous literature documents so‐called “welcome mat” effects in other populations but has not explicitly studied older persons dually eligible for Medicare and Medicaid. We extend this literature by estimating models of Medicaid participation among persons age 65 and up using American Community Survey data from 2010 to 2017 and state variation in ACA Medicaid expansions. We find that Medicaid expansions to working‐age adults increased Medicaid participation among low‐income older adults by 1.8 percentage points (4.4 percent). We also find evidence of an “on‐ramp” effect; that is, low‐income Medicare beneficiaries residing in expansion states who were young enough to gain coverage under the 2014 ACA Medicaid expansions before aging into Medicare were 4 percentage points (9.5 percent) more likely to have dual Medicaid coverage relative to similar individuals who either turned 65 before the 2014 expansions or resided in non‐expansion states. This on‐ramp effect is an important mechanism behind welcome mat effects among some older adults.     

The Reliability of Lie Detection Performance

We examined whether individuals’ ability to detect deception remained stable over time. In two sessions, held one week apart, university students viewed video clips of individuals and attempted to differentiate between the lie-tellers and truth-tellers. Overall, participants had difficulty detecting all types of deception. When viewing children answering yes–no questions about a transgression (Experiments 1 and 5), participants’ performance was highly reliable. However, rating adults who provided truthful or fabricated accounts did not produce a significant alternate forms correlation (Experiment 2). This lack of reliability was not due to the types of deceivers (i.e., children versus adults) or interviews (i.e., closed-ended questions versus extended accounts) (Experiment 3). Finally, the type of deceptive scenario (naturalistic vs. experimentally-manipulated) could not account for differences in reliability (Experiment 4). Theoretical and legal implications are discussed.     

Psychiatric diagnosis as a risk marker for victimization in a national sample of children

Research examining childhood abuse has shown an association between victimization and psychiatric diagnoses (e.g., posttraumatic stress disorder, depression). Historically, psychiatric diagnoses have been emphasized as a consequence of victimization, with less research examining if it also functions as a risk factor for further victimization, perhaps making diagnoses a general victimization risk marker. In addition, much of this research has emphasized particular types of victimization such as childhood physical or sexual abuse. Researchers have given less attention to other forms of victimization (e.g., peer victimization, witnessed violence) or a diverse victimization history. Using the Juvenile Victimization Questionnaire (JVQ) we surveyed parents and children between the ages of 2 and 17 using a random digit dial (RDD) methodology. We examined the relationship between a number of different forms of victimization (termed poly-victimization ) in the preceding year and parent-reported lifetime psychiatric diagnosis. Results show that children with a psychiatric diagnosis have significantly higher rates of victimization than children without a psychiatric diagnosis. In addition, using logistic regression models, we find that psychiatric diagnosis was associated with increased risk for poly-victimization, conventional crime victimization, maltreatment, peer or sibling victimization, and witnessing violence, but not sexual abuse. The results highlight the need to consider psychiatric diagnoses as a risk marker for past and possible future victimization. In addition, the importance of obtaining a comprehensive and more diverse victimization history when working with children is highlighted.     

Sequential lineup presentation: Patterns and policy

Sequential lineups were offered as an alternative to the traditional simultaneous lineup. Sequential lineups reduce incorrect lineup selections; however, the accompanying loss of correct identifications has resulted in controversy regarding adoption of the technique. We discuss the procedure and research relevant to (1) the pattern of results found using sequential versus simultaneous lineups; (2) reasons (theory) for differences in witness responses; (3) two methodological issues; and (4) implications for policy decisions regarding the adoption of sequential lineups.     

Risk assessment in offenders with intellectual disability: a comparison across three levels of security

In mainstream offender samples, several risk assessments have been evaluated for predictive validity. This study extends this work to male offenders with intellectual disabilities. Participants from high-, medium-, and low-security settings, as well as community settings, were compared on a range of risk assessments. The Violence Risk Appraisal Guide, HCR-20-Historical Scale, the Risk Matrix 2000-C (combined risk), and the Emotional Problems Scales-Internalising discriminated between groups, with participants from high security having higher scores than those in medium security, who had higher scores than those in the community. The Violence Risk Appraisal Guide, all HCR-20 scales, the Short Dynamic Risk Scale, and the Emotional Problems Scales (Internalising and Externalising) showed significant areas under the curve for the prediction of violence. The Static-99 showed a significant area under the curve for the prediction of sexual incidents. The discussion reviews the value of these various scales to intellectual disability services.     

Eyewitness Accuracy Rates in Sequential and Simultaneous Lineup Presentations: A Meta-Analytic Comparison

Most police lineups use a simultaneous presentation technique in which eyewitnesses view all lineup members at the same time. Lindsay and Wells (R. C. L. Lindsay & G. L. Wells, 1985) devised an alternative procedure, the sequential lineup, in which witnesses view one lineup member at a time and decide whether or not that person is the perpetrator prior to viewing the next lineup member. The present work uses the technique of meta-analysis to compare the accuracy rates of these presentation styles. Twenty-three papers were located (9 published and 14 unpublished), providing 30 tests of the hypothesis and including 4,145 participants. Results showed that identification of perpetrators from target-present lineups occurs at a higher rate from simultaneous than from sequential lineups. However, this difference largely disappears when moderator variables approximating real world conditions are considered. Also, correct rejection rates were significantly higher for sequential than simultaneous lineups and this difference is maintained or increased by greater approximation to real world conditions. Implications of these findings are discussed.     

A Preidentification Questioning Effect: Serendipitously Increasing Correct Rejections

A study designed to test the effects of delay between crime and lineup on identification accuracy produced an unusually high rate of correct rejection from target-absent, simultaneous lineups (J. E. Dysart, 1999). Examining the procedures indicated that one question included in a preidentification questionnaire differed from those used previously. The question asked witnesses if they believed they would be able to correctly reject a target-absent lineup. An experiment (N = 138) was conducted to explore the impact of preidentification questions, including this new question, on witness accuracy. Results revealed that asking witnesses these questions, prior to viewing the lineup, significantly increased correct rejections of target-absent simultaneous lineups.