Sicker and Poorer? The Role of Health Status for Welfare Leavers
- Presenter:
Chair: Curtis Florence; Discussant: Curtis Florence Mon June 5, 2006 15:30-17:00 Room 309
Rationale: Temporary Assistance for Needy Families (TANF) emerged from major welfare reform at the federal and state level in the late 1990’s. Welfare reform imposed strict time limits, work requirements, and eligibility criteria, resulting in a large drop in the welfare rolls. Studies to date have shown that a majority of former welfare recipients, or welfare leavers, did relatively well in terms of employment and income, but a subpopulation of extremely poor welfare recipients were adversely affected. In addition, many welfare leavers were dropped from Medicaid even when still eligible for coverage. An issue that has not been well addressed is the distribution of health status of welfare leavers and whether it is bimodal. In other words, welfare recipients with relatively good health status are more likely to leave welfare, but there may be a subpopulation with very poor health that also left.
Objectives: To calculate the distribution of health status among welfare leavers and its change over time, with particular attention to possible bimodality; to calculate the likelihood that a person returns to welfare versus stays off welfare in the long run as related to where they are in the health status distribution; and to calculate health insurance coverage rates for welfare leavers of different health status levels.
Data: This study will use longitudinal household survey data from the Welfare, Children, and Families Study, commonly called the Three-City Study. The data collection process involved three rounds of in-person interviews ending in 1999, 2001 and 2005, allowing researchers to study the evolving effects of welfare reform. A random sample of approximately 2,400 households with children was drawn from racially and ethnically diverse low- and middle-income neighborhoods in three cities: Boston, Chicago, and San Antonio. The study interviewed both welfare and non-welfare recipients from the same neighborhood. Among all welfare reform data sets in the country, the study is unique in sample size and in length: the sample size is larger than the low income, welfare eligible portions of the Panel Study of Income Dynamics (PSID), and is longer than the largest national panel, the Survey of Income and Program Participation.
Methodology: We will analyze survey participants who have completed all three waves. We will use the many health measures in the data set to construct an index of health status with factor analysis. We will then see how an individual’s location in this distribution affects the likelihood of leaving welfare, returning to welfare, and staying off welfare. We will examine income, employment, and health insurance coverage conditional on each of these states. Hazard models with unobserved heterogeneity will be used to examine exit from and re-entry to welfare. Income, employment, and health insurance coverage will be estimated conditional on these transitions to allow for selection bias. One’s location in the health status distribution will enter all hazards and regression equations.
Results: We have not completed our analysis and do not have results at this time. We expect to have results by the time of the conference.
