Working Paper: NBER ID: w10033
Authors: 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.
Keywords: Welfare Reform; Health Insurance; Low-Income Families
JEL Codes: I18; I38
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Welfare reform policy (I38) | Health insurance coverage for low-income families (I13) |
| Decrease in welfare caseload (I38) | Decrease in Medicaid coverage among low-educated single mothers (I18) |
| Decrease in welfare caseload (I38) | Increase in employer-sponsored private insurance coverage (I13) |
| Decrease in welfare caseload (I38) | Increase in proportion uninsured among children of low-educated single mothers (I13) |
| Welfare reform policy (I38) | Decrease in welfare caseload (I38) |
| Decrease in welfare caseload (I38) | Smaller adverse consequences on insurance status (G52) |