Changes in use of health insurance and food assistance programs in medically underserved communities in the era of welfare reform: an urban study.
OBJECTIVE
The purpose of this study was to assess changes in health insurance and food assistance enrollment following passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996.


METHODS
Extant data sources were used to calculate changes in Temporary Assistance for Needy Families (TANF), Medicaid, and Food Stamp program enrollment in medically underserved Manhattan communities after 1996.


RESULTS
Dramatic declines in TANF enrollment were accompanied by declines in Food Stamp program enrollment and a deceleration in Medicaid enrollment among several communities.


CONCLUSIONS
As the Personal Responsibility and Work Opportunity Reconciliation Act comes up for reauthorization later in 2002, policymakers should revise legislation so that needy families do not lose health insurance or food assistance support.
Departments of General Pediatrics and General Medicine, Columbia University College of Physicians and Surgeons, New York City, NY 10032, USA. sp293@columbia.edu
Susmita
S
Pati
Diana
D
Romero
Wendy
W
Chavkin
D000385:Aid to Families with Dependent Children / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D019352:Censuses; D002648:Child; D002669:Child Welfare; D004608:Eligibility Determination / Q000331:legislation & jurisprudence; D005522:Food Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008484:Medicaid / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D008507:Medically Underserved Area; D009519:New York City; D012946:Social Welfare / Q000191:economics / Q000331:legislation & jurisprudence*; D014481:United States; D014504:Urban Health