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Welfare Reform and Indirect Impacts on Health.

October 2006

Marianne P. Bitler, Public Policy Institute of California, and Hilary W. Hoynes, University of California, Davis and NBER

Download 'working_paper06-40.pdf'.


Beginning in the early 1990s, many states used waivers to reform their Aid to Families with Dependent Children (AFDC) programs. This state experimentation resulted in landmark legislation which in 1996 eliminated AFDC and replaced it with Temporary Assistance for Needy Families (TANF). TANF—like the earlier AFDC program—provides cash grants to low income families with children and is a key element of the nation’s economic safety net. The roots of this reform lie in long time concern that AFDC led to reductions in work, decreases in marriage, and increases in nonmarital births among low income women.

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. Evaluating the impacts of state and federal welfare reform is the subject of a large and growing literature.1 In this paper, we summarize what is known about the impacts of welfare reform on health insurance, health care utilization, and health status.

Health, Health Insurance, and Health Care, Welfare Reform and the Administration of Welfare Programs