From 2000 to 2003, researchers from the Nelson A. Rockefeller Institute of Government, the public policy research arm of the State University of New York, studied the effects of state implementation of welfare reform on Medicaid enrollment among low-income adults and children. They examined:
- State and local policies and practices surrounding the relationship between Medicaid and welfare.
- The nature and extent of state activities to increase enrollment in Medicaid and the State Children's Health Insurance Program (CHIP).
- Trends in Medicaid and CHIP enrollment.
- The sustainability of state enrollment enhancement efforts and Medicaid spending in the face of increasingly severe state budget problems.
The principal investigator, James W. Fossett, PhD, identified the following key project findings:
- Enrollment of low-income adults and children dropped after welfare reform, then began to increase in 1998. (Managing Medicaid Take-up: Medicaid Enrollment Trends: 1995–2000, August 2002)
- The gradual but sizable expansion of state Medicaid programs has led to the existence of an extensive and varied constituency of individuals and organizations that depend upon the program financially.
When combined with other budgetary resources that were one-shot in nature, this allowed many states to avoid substantial Medicaid cuts in fiscal year 2003 despite lagging revenues. (Managing Medicaid Take-up: Is Medicaid Retrenching? State Budgets and Medicaid Enrollment in 2002,February 2003)