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Welfare reform and health insurance coverage of low-income families

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  • Kaestner, Robert
  • Kaushal, Neeraj

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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Suggested Citation

  • 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:eee:jhecon:v:22:y:2003:i:6:p:959-981
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    Cited by:

    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. Hope Corman & Dhaval M. Dave & Dhiman Das & Nancy E. Reichman, 2013. "Effects Of Welfare Reform On Illicit Drug Use Of Adult Women," Economic Inquiry, Western Economic Association International, vol. 51(1), pages 653-674, January.
    3. repec:pri:crcwel:wp06-04-ff is not listed on IDEAS
    4. 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, May.
    5. Jean Knab & Sara McLanahan & Irv Garfinkel, 2006. "The Effects of Welfare and Child Support Policies on Maternal Health and Wellbeing," Working Papers 931, Princeton University, School of Public and International Affairs, Center for Research on Child Wellbeing..
    6. H. Elizabeth Peters & Kosali Simon & Jamie Rubenstein Taber, 2014. "Marital Disruption and Health Insurance," NBER Working Papers 20233, National Bureau of Economic Research, Inc.
    7. Lo Sasso, Anthony T. & Buchmueller, Thomas C., 2004. "The effect of the state children's health insurance program on health insurance coverage," Journal of Health Economics, Elsevier, vol. 23(5), pages 1059-1082, September.
    8. Dave, Dhaval M. & Reichman, Nancy E. & Corman, Hope & Das, Dhiman, 2011. "Effects of welfare reform on vocational education and training," Economics of Education Review, Elsevier, vol. 30(6), pages 1399-1415.
    9. 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.
    10. Bae Jung, 2020. "Immigration Relief and Insurance Coverage: Evidence from Deferred Action for Childhood Arrivals," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 20(3), pages 1-37, July.
    11. H. Peters & Kosali Simon & Jamie Taber, 2014. "Marital Disruption and Health Insurance," Demography, Springer;Population Association of America (PAA), vol. 51(4), pages 1397-1421, August.
    12. Du, Juan, 2009. "Economic reforms and health insurance in China," Social Science & Medicine, Elsevier, vol. 69(3), pages 387-395, August.
    13. 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.
    14. 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).
    15. 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).
    16. 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.
    17. Ayala, Luis & Rodríguez, Magdalena, 2013. "Health-related effects of welfare-to-work policies," Social Science & Medicine, Elsevier, vol. 93(C), pages 103-112.
    18. Aig Unuigbe, 2019. "Impact of medicaid policy changes on immigrant parents," International Journal of Health Economics and Management, Springer, vol. 19(3), pages 395-417, December.
    19. Herbst, Chris M., 2014. "Are Parental Welfare Work Requirements Good for Disadvantaged Children? Evidence from Age-of-Youngest-Child Exemptions," IZA Discussion Papers 8485, Institute of Labor Economics (IZA).
    20. 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.
    21. Vaughn, Cody N., 2023. "Welfare reform and childhood health status and utilization," Children and Youth Services Review, Elsevier, vol. 150(C).
    22. Bronchetti, Erin Todd, 2014. "Public insurance expansions and the health of immigrant and native children," Journal of Public Economics, Elsevier, vol. 120(C), pages 205-219.
    23. Hua Zan & Robert L. Scharff, 2018. "The Effects of Children’s Health on Mothers’ Employment," Journal of Family and Economic Issues, Springer, vol. 39(2), pages 297-309, June.

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    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

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