title: Welfare reform, insurance coverage pre-pregnancy, and timely enrollment: an eight-state study.
abstract: Implementation of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) broke the automatic linkage between Medicaid eligibility/enrollment and welfare cash assistance for women eligible at welfare income levels. This study used data from the Pregnancy Risk Assessment Monitoring System (PRAMS) for the period 1996-1999 to examine insurance coverage of these and other pregnant women pre- and post-PRWORA. Controlling for individual characteristics and economic growth, the relative odds of having private insurance did not change while the odds of being Medicaid enrolled versus uninsured pre-pregnancy declined for welfare-eligible women post-PRWORA. The absolute effect was a decline of 7.9 percentage points in the probability of welfare-eligible women being insured. While these results apply to the early years of welfare reform, it is still likely that states can improve Medicaid outreach and enrollment of women eligible prior to pregnancy.
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA. eadam01@sph.emory.edu
authors.forename: E Kathleen
authors.initials: EK
authors.lastname: Adams
authors.forename: Norma I
authors.initials: NI
authors.lastname: Gavin
authors.forename: Willard G
authors.initials: WG
authors.lastname: Manning
authors.forename: Arden
authors.initials: A
authors.lastname: Handler
mesh_terms: D000293:Adolescent; D000328:Adult; D004608:Eligibility Determination / Q000191:economics* / Q000331:legislation & jurisprudence; D005260:Female; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D016015:Logistic Models; D008484:Medicaid / Q000706:statistics & numerical data; D011203:Poverty; D011247:Pregnancy; D011295:Prenatal Care / Q000191:economics* / Q000331:legislation & jurisprudence; D011632:Public Assistance / Q000331:legislation & jurisprudence*; D011640:Public Policy; D014481:United States