Abstract
OBJECTIVES: This study sought to determine whether there is a relationship between state policies on Temporary Assistance to Needy Families (TANF), declines in both TANF and Medicaid caseloads, and the rise in the number of uninsured. METHODS: Extant data sources of state TANF policies, TANF and Medicaid participation, and uninsurance rates were analyzed, with the state as the unit of analysis. The independent variables included state TANF policies that directly address receipt of benefits or relate to health; dependent variables included changes in state TANF enrollment, Medicaid enrollment, and health insurance status since the enactment of the law. RESULTS: In the bivariate analysis, declines in Medicaid were associated with sanction for work noncompliance, lack of a child care guarantee, and strategies to deter TANF enrollment; this last factor was also associated with increased uninsurance. In the multivariate analysis, lack of a child care guarantee and deterrent strategies predicted TANF declines; deterrent strategies predicted Medicaid decline and uninsurance increases. CONCLUSIONS: This analysis suggests that policies deterring TANF enrollment may contribute to declines in Medicaid and increased uninsurance. To maintain health insurance for the poor, policymakers should consider revising policies that deter TANF enrollment.
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Selected References
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- Bassuk E. L., Browne A., Buckner J. C. Single mothers and welfare. Sci Am. 1996 Oct;275(4):60-3, 66-7. doi: 10.1038/scientificamerican1096-60. [DOI] [PubMed] [Google Scholar]
- Braveman P., Bennett T., Lewis C., Egerter S., Showstack J. Access to prenatal care following major Medicaid eligibility expansions. JAMA. 1993 Mar 10;269(10):1285–1289. [PubMed] [Google Scholar]
- Davis M. F. Welfare reform: a women's health perspective. J Am Med Womens Assoc. 1996 Aug-Oct;51(4):166–170. [PubMed] [Google Scholar]
- Garrett B., Holahan J. Health insurance coverage after welfare. Health Aff (Millwood) 2000 Jan-Feb;19(1):175–184. doi: 10.1377/hlthaff.19.1.175. [DOI] [PubMed] [Google Scholar]
- Joyce T. Impact of augmented prenatal care on birth outcomes of Medicaid recipients in New York City. J Health Econ. 1999 Jan;18(1):31–67. doi: 10.1016/s0167-6296(98)00027-7. [DOI] [PubMed] [Google Scholar]