Health care coverage for children who are on and off welfare

Access to adequate health insurance is a key concern of families with children at all income levels. Since 1965, mothers and children on welfare have had health care coverage through the Medicaid program, which has provided a health care safety net for welfare recipients. Although most Americans are insured through their employers, families who leave welfare for employment often find themselves in jobs that do not offer health care coverage, adding to the ranks of the uninsured. This article examines the extent to which poor children and their mothers have private insurance, Medicaid, or no health insurance at all. It documents how recent expansions of Medicaid eligibility to low-income children who do not receive welfare have improved the insurance status of children, though these changes have not helped the mothers who leave welfare for work. Citing evidence that health insurance options influence the welfare and employment decisions of women whose families face health problems, the article suggests that implementing welfare reform at a time when rates of private insurance coverage are declining will be challenging and may expose some families to health risks.