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Welfare reform consequences for children: the Wisconsin experience.
E Willis1, M Malloy, R M Kliegman
1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. ewillis@mcw.edu
Pediatrics
|January 11, 2000
Summary
Wisconsin welfare reform led to significant drops in enrollment for programs like AFDC and Medicaid among children. However, the non-linked WIC program saw minimal declines, highlighting the impact of program linkage on safety-net access for infants and children.
Area of Science:
- Public Health
- Health Services Research
- Social Policy
Background:
- The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 introduced Temporary Assistance for Needy Families (TANF), impacting many working families.
- Child advocates expressed concern over potential negative consequences for infants and children as safety-net programs became unlinked.
- Wisconsin's welfare reform initiatives, particularly the transition from Aid to Families with Dependent Children (AFDC) to Wisconsin Works (W-2), prompted an examination of program enrollment.
Purpose of the Study:
- To analyze the enrollment trends of infants and children in linked and non-linked safety-net programs in Wisconsin between January 1995 and August 1998.
- To compare enrollment changes in AFDC, Medicaid/AFDC, Medicaid/Healthy Start, and Food Stamps with the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) during welfare reform.
- To assess the impact of welfare reform on the accessibility of essential support services for vulnerable children.
Main Methods:
- A cross-sectional analysis of monthly enrollment data for infants and children (birth to 18 years) in Wisconsin.
- Enrollment data was examined across three distinct periods: pre-welfare reform (AFDC), welfare reform pilot (Pay For Performance), and post-welfare reform (W-2).
- Key programs monitored included AFDC/W-2, WIC, Food Stamps, Medicaid/AFDC, and Medicaid/Healthy Start.
Main Results:
- Significant declines in AFDC and Medicaid/AFDC enrollment were observed, with over 111,000 children removed from AFDC/W-2 and 51,559 fewer children benefiting from Medicaid.
- Food Stamp enrollment also decreased substantially across all study periods.
- In contrast, Medicaid/Healthy Start enrollment increased, and WIC enrollment showed statistically non-significant declines compared to AFDC-linked programs.
Conclusions:
- Wisconsin's welfare reform resulted in unprecedented removal of infants and children from welfare rolls, demonstrating the significant impact of linking safety-net programs to AFDC/W-2.
- The non-linked WIC program's enrollment stability suggests that its independent certification process buffered against the declines seen in AFDC-linked programs.
- Targeted interventions, such as outreach for Medicaid/Healthy Start and State Children Health Insurance Program (Title XXI), helped mitigate Medicaid enrollment reductions, underscoring the importance of careful program transition during policy changes.