Welfare Reform and Health Insurance Coverage of Low-Income Families

Robert Kaestner, University of Illinois at Chicago
Neeraj Kaushal, Columbia University

We study whether welfare reform adversely affected the health insurance coverage of low-educated single mothers and their children. 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 welfare reform decreased Medicaid coverage, increased employer-sponsored private insurance coverage, and increased the proportion uninsured. The magnitudes of the effects were relatively small. For example, between 1996 and 1999, changes in the caseload were associated with a decrease in Medicaid coverage among single mothers of four to five percentage points; an increase in private insurance coverage of approximately two percentage points; and an increase of two to three percentage points in the proportion of low-educated, single mothers who were uninsured. Among children of low-educated, single mothers, welfare reform had smaller effects.