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Welfare Reform and Indirect Impacts on Health

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  • Marianne Bitler
  • Hilary W. Hoynes

Abstract

The stated goals of welfare reform are to increase work, reduce dependency on welfare, reduce births outside marriage, and to increase the formation of two parent families. However, welfare reform may also have indirect impacts on health. We provide a comprehensive review of the literature on the impacts of welfare reform on health. We illustrate the main findings from the literature by presenting estimates of the impact of reform on health insurance, health utilization, and health status using data from five state waiver experiments. The most consistent finding is that welfare reform led to a reduction in health insurance coverage. The impacts on health care utilization and health status tend to be more mixed and fewer are statistically significant. While the results are not conclusive, they suggest that welfare-to-work programs need not have large negative health effects.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 12642.

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Date of creation: Oct 2006
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Publication status: published as Schoeni, R., J. House, G. Kaplan, and H. Pollack (eds.) Making Americans Healthier: Social and Economic Policy as Health Policy. New York: Russell Sage, 2008.
Handle: RePEc:nbr:nberwo:12642

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  1. Robert Kaestner & Won Chan Lee, 2005. "The effect of welfare reform on prenatal care and birth weight," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 497-511.
  2. Jonathan Gruber, 1996. "Health Insurance for Poor Women and Children in the U.S.: Lessons from the Past Decade," NBER Working Papers 5831, National Bureau of Economic Research, Inc.
  3. Janet Currie & Aaron Yelowitz, 1999. "Health Insurance and Less Skilled Workers," NBER Working Papers 7291, National Bureau of Economic Research, Inc.
  4. Bitler, Marianne P. & Gelbach, Jonah B. & Hoynes, Hilary W., 2005. "What Mean Impacts Miss: Distributional Effects of Welfare Reform Experiments," IZA Discussion Papers 1728, Institute for the Study of Labor (IZA).
  5. Michael Anderson, 2005. "Uncovering Gender Differences in the Effects of Early Intervention: A Reevaluation of the Abecedarian, Perry Preschool, and Early Training Projects," HEW, EconWPA 0509008, EconWPA, revised 26 Sep 2005.
  6. 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).
  7. Rebecca M. Blank, 2002. "Evaluating Welfare Reform in the United States," NBER Working Papers 8983, National Bureau of Economic Research, Inc.
  8. Steven J. Haider & Alison Jacknowitz & Robert F. Schoeni, 2002. "Welfare Work Requirements and Individual Well-being: Evidence from the Effects on Breastfeeding," Working Papers, RAND Corporation Publications Department 02-01, RAND Corporation Publications Department.
  9. Jeffrey R. Kling & Jeffrey B. Liebman & Lawrence F. Katz, 2005. "Experimental Analysis of Neighborhood Effects," NBER Working Papers 11577, National Bureau of Economic Research, Inc.
  10. David Card & Carlos Dobkin & Nicole Maestas, 2004. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health: Evidence from Medicare," Working Papers, RAND Corporation Publications Department 197, RAND Corporation Publications Department.
  11. Rebecca M. Blank, 2001. "Declining caseloads/increased work: what can we conclude about the effects of welfare reform?," Economic Policy Review, Federal Reserve Bank of New York, Federal Reserve Bank of New York, issue Sep, pages 25-36.
  12. Steven Haider & Alison Jacknowitz & Robert Schoeni, 2003. "Welfare work requirements and child well-being: Evidence from the effects on breast-feeding," Demography, Springer, Springer, vol. 40(3), pages 479-497, August.
  13. Price V. Fishback & Michael R. Haines & Shawn Kantor, 2007. "Births, Deaths, and New Deal Relief during the Great Depression," The Review of Economics and Statistics, MIT Press, vol. 89(1), pages 1-14, February.
  14. James Hines & Hilary Hoynes & Alan Krueger, 2001. "Another Look at Whether a Rising Tide Lifts All Boats," Working Papers, Princeton University, Department of Economics, Industrial Relations Section. 833, Princeton University, Department of Economics, Industrial Relations Section..
  15. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, University of Chicago Press, vol. 104(6), pages 1263-96, December.
  16. Robert Moffitt, 2002. "Welfare Programs and Labor Supply," NBER Working Papers 9168, National Bureau of Economic Research, Inc.
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  18. Currie, Janet & Gruber, Jonathan, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, MIT Press, MIT Press, vol. 111(2), pages 431-66, May.
  19. Kling, Jeffrey & Liebman, Jeffrey, 2004. "Experimental Analysis of Neighborhood Effects on Youth," Working Paper Series, Harvard University, John F. Kennedy School of Government rwp04-034, Harvard University, John F. Kennedy School of Government.
  20. Thomas DeLeire & Judith A. Levine & Helen Levy, 2006. "Is Welfare Reform Responsible for Low-Skilled Women’s Declining Health Insurance Coverage in the 1990s?," Journal of Human Resources, University of Wisconsin Press, vol. 41(3).
  21. Currie, Janet & Cole, Nancy, 1993. "Welfare and Child Health: The Link between AFDC Participation and Birth Weight," American Economic Review, American Economic Association, American Economic Association, vol. 83(4), pages 971-85, September.
  22. George J. Borjas, 2003. "Welfare Reform, Labor Supply, and Health Insurance in the Immigrant Population," NBER Working Papers 9781, National Bureau of Economic Research, Inc.
  23. 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.
  24. repec:fth:prinin:454 is not listed on IDEAS
  25. Anna Aizer & Jeffrey Grogger, 2003. "Parental Medicaid Expansions and Health Insurance Coverage," NBER Working Papers 9907, National Bureau of Economic Research, Inc.
  26. Busch, Susan H. & Duchovny, Noelia, 2005. "Family coverage expansions: Impact on insurance coverage and health care utilization of parents," Journal of Health Economics, Elsevier, Elsevier, vol. 24(5), pages 876-890, September.
  27. Jacob Alex Klerman & Steven J. Haider, 2004. "A Stock-Flow Analysis of the Welfare Caseload," Journal of Human Resources, University of Wisconsin Press, vol. 39(4).
  28. Rebecca M. Blank, 1999. "What Goes Up Must Come Down? Explaining Recent Changes in Public Assistance Caseloads," JCPR Working Papers, Northwestern University/University of Chicago Joint Center for Poverty Research 78, Northwestern University/University of Chicago Joint Center for Poverty Research.
  29. Jeffrey R. Kling & B. Jeffrey Liebman, 2004. "Experimental Analysis of Neighborhood Effects on Youth," Working Papers, Princeton University, Department of Economics, Industrial Relations Section. 862, Princeton University, Department of Economics, Industrial Relations Section..
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Cited by:
  1. Jane Waldfogel, 2007. "Welfare Reforms and Child Well-Being in the US and UK," CASE Papers, Centre for Analysis of Social Exclusion, LSE /126, Centre for Analysis of Social Exclusion, LSE.
  2. Chris Herbst, 2013. "Welfare reform and the subjective well-being of single mothers," Journal of Population Economics, Springer, Springer, vol. 26(1), pages 203-238, January.
  3. Jane Waldfogel, 2007. "Welfare reforms and child well-being in the US and UK," LSE Research Online Documents on Economics, London School of Economics and Political Science, LSE Library 6208, London School of Economics and Political Science, LSE Library.

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