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The impact of welfare reform on the health insurance coverage, utilization and health of low education single mothers

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  • Narain, Kimberly
  • Bitler, Marianne
  • Ponce, Ninez
  • Kominski, Gerald
  • Ettner, Susan

Abstract

The Personal Responsibility Work Opportunity and Reconciliation Act (PRWORA) of 1996 imposed time limits on the receipt of welfare cash benefits and mandated cash benefit sanctions for failure to meet work requirements. Many studies examining the health implications of PRWORA have found associated declines in health insurance coverage and healthcare utilization among single mothers but no impact of PRWORA on health outcomes. A limitation of this literature is that most studies cover a time period before time limits were implemented in all states and also before individuals began actually timing out. This work builds on previous studies by exploring this research question using data from the Survey of Income and Program Participation that covers a time period after all states have implemented time limits (1991–2009). We use a difference-in-differences study design that exploits variability in eligibility for cash welfare benefits by marital status and state-level variation in timing of PRWORA implementation to identify the effect of PRWORA. Using ordinary least square regression models, controlling for state-level and federal policies, individual-level demographics and state and year fixed-effects, we find that PRWORA leads to 7 and 5 percentage point increases in self-reported poor health and self-reported disability among white single mothers without a diploma, respectively.

Suggested Citation

  • Narain, Kimberly & Bitler, Marianne & Ponce, Ninez & Kominski, Gerald & Ettner, Susan, 2017. "The impact of welfare reform on the health insurance coverage, utilization and health of low education single mothers," Social Science & Medicine, Elsevier, vol. 180(C), pages 28-35.
    • Handle: RePEc:eee:socmed:v:180:y:2017:i:c:p:28-35
    DOI: 10.1016/j.socscimed.2017.03.021
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    References listed on IDEAS

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    1. Marianne P. Bitler & Jonah B. Gelbach & Hilary W. Hoynes, 2005. "Welfare Reform and Health," Journal of Human Resources, University of Wisconsin Press, vol. 40(2).
    2. Jagannathan, Radha & Camasso, Michael J. & Sambamoorthi, Usha, 2010. "Experimental evidence of welfare reform impact on clinical anxiety and depression levels among poor women," Social Science & Medicine, Elsevier, vol. 71(1), pages 152-160, July.
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    2. Simpson, Julija & Bambra, Clare & Brown, Heather, 2021. "Do Changes in Employment and Hours Worked Contribute to a Decreasing in the Mental Health of Single Mothers during a Period of Welfare Reform in the UK? A Longitudinal Analysis (2009-2019)," IZA Discussion Papers 14968, Institute of Labor Economics (IZA).
    3. Hicks, Jeffrey & Simard-Duplain, Gaëlle & Green, David A. & Warburton, William, 2022. "The effect of reducing welfare access on employment, health, and children's long-run outcomes," CLEF Working Paper Series 51, Canadian Labour Economics Forum (CLEF), University of Waterloo.
    4. Anoshua Chaudhuri, 2021. "Health Research in JFEI Over a Decade: 2009–2019," Journal of Family and Economic Issues, Springer, vol. 42(1), pages 142-153, July.
    5. Otto Lenhart, 2019. "The effects of income on health: new evidence from the Earned Income Tax Credit," Review of Economics of the Household, Springer, vol. 17(2), pages 377-410, June.
    6. Lauren E. Jones & Guangyi Wang & Tansel Yilmazer, 2022. "The long‐term effect of the Earned Income Tax Credit on women's physical and mental health," Health Economics, John Wiley & Sons, Ltd., vol. 31(6), pages 1067-1102, June.

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    Keywords

    TANF; Medicaid;

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