FROM WELFARE TO MEDICAID: Assessing the System

The Urban Institute, a nonpartisan think tank, has published "Assessing the New Federalism," a series of reports that examine the recent shift in responsibility from the federal government to the states for providing citizens with health care and social services. The July series looks at how the declining number of welfare recipients has affected the number of California and Florida families receiving Medicaid; the study's purpose is to "fill several gaps in understanding of Medicaid enrollment patterns."

The California Experience
Researchers used data from HCFA's State Medicaid Research Files to "track when individuals were on and off Medicaid." They found that declining welfare rolls corresponded directly with declining Medicaid rolls. By the end of 1995, for example, the number of Aid to Families with Dependent Children (AFDC) recipients had dropped by 2%, the same decrease in Medicaid rolls. Below is an excerpt from the study:

"In 1995 ... half the children leaving AFDC left Medicaid as well. We found this same pattern with adults in California. ... Transitional assistance [to cover the welfare to work period] was used by only 6% of the adults in California six months after AFDC exit." The study concludes that "outreach efforts" related to the Children's Health Insurance Program may eventually spur eligible families to enroll in Medicaid, but that refocused efforts need to be made "to ensure that children (and their parents) remain in the program as long as they are eligible" (7/99). Click here to access "On and Off Medicaid: Enrollment Patterns for California and Florida in 1995," by Marilyn Ellwood and Kimball Lewis of Mathmatica Policy Research, Inc. This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.