What You Don't Know Can Hurt You: Leaving Welfare Doesn't Always Mean Giving Up Medicaid

Improving access to health benefits for welfare and low-income families in the South

From 1997 to 1999, staff at the Southern Institute on Children and Families (SICF) conducted a project designed to improve awareness among low-income families about benefits for which they are eligible, including Medicaid and child care.

During the project, staff:

  • Conducted site visits to 17 southern states and the District of Columbia.
  • Produced information outreach videos.
  • Established a Web site.
  • Convened several meetings on issues surrounding Medicaid eligibility.
  • Provided technical assistance to states on implementing information outreach efforts.

The Southern Institute on Children and Families is a nonprofit public policy organization located in Columbia, S.C.

Key Findings and Recommendations

In their report on the project—Southern Regional Initiative to Improve Access to Benefits for Low Income Families With Children—project staff included the following findings:

  • Many families do not understand that they may still be eligible for Medicaid benefits even if they are not receiving cash assistance.
  • Federal rules may actually encourage families transitioning off welfare to apply for cash assistance in order to obtain transitional Medicaid coverage.
  • While several states have implemented exemplary outreach initiatives to improve access to Medicaid and other benefits, most states have not done so.

Among the policy changes recommended by the project team were that states and communities:

  • Design and implement aggressive outreach strategies to improve access to health coverage for children.
  • Make the application process less burdensome for families, so more families could access these benefits.
  • Do more to encourage employment among low-income families by assisting with child care and developing alternatives for people lacking transportation to jobs.


The Robert Wood Johnson Foundation (RWJF) supported this project through a grant of $497,250.