The premise of the welfare reform law of 1996 was that "reform" of the welfare system would lead to an increase in personal responsibility and self sufficiency among the poor, with a strong focus on controlling both maternal behavior and reproductive decision-making. State governments mandated specific behaviors of women with economic sanctions for noncompliance (eg, child exclusion ["family caps"], drug testing, family planning, immunization, educational and residency requirements). However, the legislation was devoid of measures ensuring or providing for the health and well-being of welfare recipients. This is particularly significant given that the impoverished have a disproportionate share of health problems and disability compared with the rest of society. This research focuses on the intersection of health with poverty, and maintains that policies attempting to safeguard the health and well-being of poor children will not be successful if they concurrently penalize their mothers. The disjuncture between the state Child Health Insurance Program (CHIP) and Medicaid is illustrative. Since CHIP's creation in 1997, enrollment of poor children has been below expected levels. Over the same period, Medicaid enrollment of both children and women has declined. We present our findings from an analysis of state TANF policy choices and their relationship to Medicaid enrollment and overall uninsurance rates. We conclude that changes in these other support programs emanate from restrictive policies related to cash assistance which have deterred poor families from seeking out health services to which they are likely entitled. We present national data specifically related to reproductive health policies.
Learning Objectives: Participants will learn about the reproductive health requirements that were built into the welfare reform legislation. A review of exisiting evaluations of these policies will be presented. At the conclusion, attendees will be able to identify other relevant factors and assess the relative impact of reproductive health requirements associated with state welfare programs
Keywords: Reproductive Health, Welfare Reform
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.