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Welfare Reform and Health Insurance Coverage of Low-Income Families

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  • Robert Kaestner
  • Neeraj Kaushal

Abstract

We study whether welfare reform adversely affected the health insurance coverage of low-educated single mothers and their children. Specifically, we investigate whether changes in the welfare caseload during the 1990s were associated with changes in Medicaid participation, private insurance coverage, and the number of uninsured among single mothers and their children. Estimates suggest that between 1996 and 1999, the 42 percent decrease in the welfare caseload was associated with the following changes in insurance coverage among low-educated, single mothers: a seven to nine percent decrease in Medicaid coverage; an increase in employer-sponsored, private insurance coverage of six percent; and a two to nine percent increase in the proportion uninsured. Among children of low-educated, single mothers, effects were somewhat smaller. Since welfare policy was responsible for only part (e.g., one-third) of the decline in the caseload, welfare reform per se had significantly smaller effects on the health insurance status of low-income families. However, we found limited evidence that changes in the caseload due to state and federal welfare policy had fewer adverse consequences on insurance status than changes in the caseload due to other factors. This implies even smaller effects of welfare reform.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 10033.

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Date of creation: Oct 2003
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Publication status: published as Kaestner, Robert & Kaushal, Neeraj, 2003. "Welfare reform and health insurance coverage of low-income families," Journal of Health Economics, Elsevier, vol. 22(6), pages 959-981, November.
Handle: RePEc:nbr:nberwo:10033

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  1. Neeraj Kaushal & Robert Kaestner, 2001. "From Welfare to Work: Has Welfare Reform Worked?," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 20(4), pages 699-719.
  2. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2002. "How Much Should We Trust Differences-in-Differences Estimates?," NBER Working Papers 8841, National Bureau of Economic Research, Inc.
  3. Rebecca M. Blank, 2002. "Evaluating Welfare Reform in the United States," Journal of Economic Literature, American Economic Association, vol. 40(4), pages 1105-1166, December.
  4. Janet Currie & Jeffrey Grogger, 2000. "Medicaid Expansions and Welfare Contractions: Offsetting Effects on Prenatal Care and Infant Health?," NBER Working Papers 7667, National Bureau of Economic Research, Inc.
  5. Cutler, David M & Gruber, Jonathan, 1996. "Does Public Insurance Crowd Out Private Insurance?," The Quarterly Journal of Economics, MIT Press, vol. 111(2), pages 391-430, May.
  6. Janet Currie & Aaron S. Yelowitz, 1999. "Health Insurance and Less Skilled Workers," JCPR Working Papers 63, Northwestern University/University of Chicago Joint Center for Poverty Research.
  7. Schoeni, R.F. & Blank, R.M., 2000. "What Has Welfare Reform Accomplished? Impacts on Welfare Participation, Employment, Income, Poverty, and Family Structure," Papers 00-02, RAND - Labor and Population Program.
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Cited by:
  1. Ayala, Luis & RodrĂ­guez, Magdalena, 2013. "Health-related effects of welfare-to-work policies," Social Science & Medicine, Elsevier, vol. 93(C), pages 103-112.
  2. 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).
  3. Robert Kaestner & Won Chan Lee, 2003. "The Effect of Welfare Reform on Prenatal Care and Birth Weight," NBER Working Papers 9769, National Bureau of Economic Research, Inc.
  4. Jean Knab & Sara McLanahan & Irv Garfinkel, 2007. "The Effects of Welfare and Child Support Policies on Maternal Health and Wellbeing," Working Papers 931, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Research on Child Wellbeing..
  5. Anthony T. LoSasso & Thomas C. Buchmueller, 2002. "The Effect of the State Children's Health Insurance Program on Health Insurance Coverage," NBER Working Papers 9405, National Bureau of Economic Research, Inc.
  6. Gennetian, Lisa A. & Hill, Heather D. & London, Andrew S. & Lopoo, Leonard M., 2010. "Maternal employment and the health of low-income young children," Journal of Health Economics, Elsevier, vol. 29(3), pages 353-363, May.
  7. David Zimmer, 2011. "The Effects of the State Children’s Health Insurance Program on Insurance Status and Health Care Utilization of Children," Journal of Family and Economic Issues, Springer, vol. 32(2), pages 373-383, June.

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