Overhauling welfare: implications for reproductive health policy in the United States

The overhaul of the welfare system in 1996 broke the historic link between eligibility for welfare benefits and eligibility for Medicaid, ended a longstanding requirement that welfare recipients be given access to family planning services, and, at the same time, included a number of controversial features directed at reducing out-of-wedlock childbearing and promoting abstinence-only education. Five years later, the number of women enrolled in Medicaid is down, the number not covered by insurance is up, and abstinence-only education has become a prominent feature of the government's effort to decrease the incidence of out-of-wedlock pregnancies. Very little is known about how well these interventions are working and what impact, positive or negative, they have had. As Congress heads for reauthorization of the nation's welfare law later this year, policy makers should give increased attention to the provision of information and services, including those related to family planning, in order to better address the reproductive health needs of low-income women.