Welfare and Immigration Reforms: Unintended Side Effects for Medicaid

Health Affairs

Volumn 17, Issue 3, 1998, Pages 137-151

  Ellwood, Marilyn R ^a   Ku, Leighton ^b  

^a MATHEMATICA POLICY RESEARCH   (United States)

^b URBAN INSTITUTE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ARTICLE; CHILD; ECONOMICS; GOVERNMENT; HEALTH CARE PLANNING; HEALTH CARE POLICY; HUMAN; LEGAL ASPECT; MEDICAID; MIGRATION; ORGANIZATION AND MANAGEMENT; SOCIAL WELFARE; UNITED STATES; UTILIZATION REVIEW;

ADULT; CHILD; ELIGIBILITY DETERMINATION; EMIGRATION AND IMMIGRATION; HEALTH CARE REFORM; HEALTH POLICY; HUMANS; MEDICAID; SOCIAL WELFARE; STATE GOVERNMENT; STATE HEALTH PLANS; UNITED STATES;

EID: 0032058865     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.17.3.137     Document Type: Article

References (23)

1. Congressional Budget Office, Federal Budgetary Implications of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (Washington: CBO, December 1996).
2. R. Pear, "Governors Split over Need for Changes to New Welfare Law," New York Times, 2 February 1997, A6.
3. For more details, see A. Kondratas, A. Weil, and N. Goldstein, "Assessing the New Federalism: An Introduction," in this volume of Health Affairs.
4. S. Rosenbaum and J. Darnell, An Analysis of the Medicaid and Health-Related Provisions of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104-193) (Washington: Kaiser Commission on the Future of Medicaid, February 1997).
5. These asset limits primarily affect Medicaid eligibility for adults, since the majority of states eliminated assets tests for poverty-related child coverage.
6. By federal law, medically needy income thresholds cannot exceed 133 percent of the AFDC income thresholds, by family size.
7. AFDC rules greatly limit the eligibility of two-parent families. Unless the second parent is disabled or works fewer than 100 hours a month, families with both parents in the home are generally ineligible for coverage.
8. M.R. Ellwood and B. Burwell, "Access to Medicaid and Medicare by the Low-Income Disabled," Health Care Financing Review (1990 Annual Supplement): 133-148.
9. S.C. Shuptrine and G.G. McKenzie, Information Outreach to Reduce Welfare Dependency (Columbia, S.C.: Southern Institute on Children and Families, May 1996).
10. L. Dubay and G. Kenney, "The Effects of Medicaid Expansions on Insurance Coverage of Children," The Future of Children 6, no. 1 (1996): 152-161.
11. J. Kaplan, Transitional Medicaid Assistance (Washington: Welfare Information Network, December 1997).
12. AFDC/TANF participation levels vary from those for AFDC/Medicaid for various technical reasons but are broadly consistent. One factor is that AFDC/TANF uses average monthly participation, whereas Medicaid data are for those persons ever enrolled in a year.
13. "Dwindling Medicaid Rolls Mean Rough Ride for HMOs," Medicine and Health 52, no. 8 (1998): 2.
14. For example, see Council of Economic Advisers, Technical Report: Explaining the Decline in Welfare Receipt, 1993-1996 (Washington: White House, May 1997); and A. Martini and M. Wiseman, Explaining the Recent Decline in Welfare Caseloads: Is the Council of Economic Advisers Right? (Washington: Urban Institute, July 1997).
15. For example, see Council of Economic Advisers, Technical Report: Explaining the Decline in Welfare Receipt, 1993-1996 (Washington: White House, May 1997); and A. Martini and M. Wiseman, Explaining the Recent Decline in Welfare Caseloads: Is the Council of Economic Advisers Right? (Washington: Urban Institute, July 1997).
16. P. Fronstin, "Sources of Health Insurance and Characteristics of the Uninsured: Analysis of the March 1997 Current Population Survey," EBRI Issue Brief 192 (Washington: Employee Benefit Research Institute, December 1997).
17. PRUCOL is an umbrella term for a number of special categories of people whose immigration status is in a "gray zone," such as those for whom deportation is being withheld or suspended.
18. L. Ku and B. Kessler, The Number and Costs of Immigrants on Medicaid: National and State Estimates (Washington: Urban Institute, December 1997).
19. Ibid.
20. R.A. Moffitt and E. Slade, "Health Care Coverage for Children On and Off Welfare," The Future of Children 7, no. 1 (1997): 87-98.
21. P. Fronstin, "Sources of Health Insurance and Characteristics of the Uninsured: Analysis of the March 1996 Current Population Survey," EBRI Issue Brief 179 (Washington: EBRI, November 1996).
22. C. Schoen et al., "Insurance Matters for Low-Income Adults: Results from a Five-State Survey," Health Affairs (September/October 1997): 163-171.
23. G. Acs and P. Loprest, "The Effect of Disabilities on Exits from AFDC" (forthcoming).