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February 2005, Vol 95, No. 2 | American Journal of Public Health 279-285
© 2005 American Public Health Association
DOI: 10.2105/AJPH.2003.025882

RESEARCH AND PRACTICE

Welfare Reform and Health Insurance: Consequences for Parents

Jane L. Holl, MD, MPH, Kristen Shook Slack, PhD and Amy Bush Stevens, MSW, MPH

Jane L. Holl is with the Institute for Health Services Research and Policy Studies and Departments of Pediatrics and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill. Kristen Shook Slack is with the School of Social Work, University of Wisconsin, Madison. Amy Bush Stevens is with Owl Creek Consulting, Gambier, Ohio.

Correspondence: Requests for reprints should be sent to Jane L. Holl, MD, MPH, Institute for Health Services Research and Policy Studies, 339 E Chicago Ave, Room 713, Chicago, IL 60611–3071 (e-mail: j-holl{at}northwestern.edu).

Objectives. We assessed the relation between the work promotion, welfare reduction, and marriage goals of welfare reform and the stability of health insurance of parents in transition from welfare to work.

Methods. We analyzed a panel survey (1999–2002) of a stratified random sample of Illinois families receiving welfare in 1998 (n=1363).

Results. Medicaid remains the foremost source of health insurance despite a significant decline in the proportion of parents with Medicaid. Regardless of work/welfare status in year 1, transitioning to work only or no work/no welfare increased the likelihood of having unstable health insurance in years 2 and 3 compared with those who remained on welfare only.

Conclusions. Parents who meet the welfare reform goals of work promotion and reduction of welfare dependence experience significant loss and instability of health insurance.




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E. Hildebrandt and P. Stevens
Impoverished Women With Children and No Welfare Benefits: The Urgency of Researching Failures of the Temporary Assistance for Needy Families Program
Am J Public Health, May 1, 2009; 99(5): 793 - 801.
[Abstract] [Full Text] [PDF]


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