Welfare Law Creates More Uninsured

From 1997 to 2000, researchers at the George Washington University Center for Health Services Research and Policy studied the effects of the health-related provisions of the Welfare Reform Act of 1996 and their implications for access to Medicaid and for safety net providers.

The research team gathered data through surveys of patients and staff from health centers and state agencies, interviews with state officials, and case studies.

Key Findings

  • The diversion process in the states has fundamentally altered conditions for access to Medicaid.

  • States have failed to recognize the need to restructure their Medicaid programs in response to the new welfare paradigm of "work instead of welfare."

  • Serious deficiencies exist in federal qualified health center outstation activities.

  • The 1996 reform laws effectively created more uninsured people by denying Medicaid access to legal permanent residents, resulting in additional strain on the provider safety net.