A qualitative study of the effects of 1996 federal welfare reform legislation on the health of Chicago’s welfare populations provided information on the following topics: 1) decline in Medicaid enrollment, 2) relationship to CHIP program, 3) growing population of working poor, 4) fragmentation of support services, 5) relationship between child care, domestic violence, hunger, and medical care, 6) negative relationships with Human Services representatives. While most research has concentrated on the “success” of moving people into the workforce, we used focus groups and interviews with local health leaders to understand the health consequences and propose several strategies that may be used by other states attempting to alleviate negative health effects of welfare reform. Focus groups were held with different segments of Chicago’s welfare population to discuss differences in quality and access to health care between time receiving TANF benefits and moving to work. Participants reported that they were often forced to switch health plans, primary care physician, coerced into a Medicaid managed care plan. Participants also had little knowledge of the CHIP program, and reported that Human Services caseworkers provided little information about support services including transitional Medicaid, CHIP, post-secondary education, and food stamps. Human Services case managers were often confused about the details of TANF laws, and provided the most information about established human services job-training programs. A working group consisting of state legislators, community leaders, advocates from various disciplines, researchers, and medical providers was convened to develop policy proposals which are being presented to local policy makers.
Learning Objectives: 1) Understand the health effects of welfare reform in Chicago’s diverse welfare populations. 2) Develop a state advocacy agenda that takes advantage of legislative provisions as well as builds upon individual state resources
Keywords: 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.