As mentioned earlier, there were significant caseload declines in public benefit programs in the years immediately following the enactment of PRWORA.9 Legal immigrants' use of public assistance declined as well and while some of this decline may have been due to changes in eligibility, there was some speculation that some of the decline may have been the result of caseworkers and clients having difficulty distinguishing between eligible and ineligibility immigrants.10 As of 1999, when only low-income families are considered, legal immigrants with children had lower participation rates for TANF and food stamps than their low-income citizen counterparts, but Medicaid participation was on par with participation among citizen families (Fix and Passel 2002). Another possible explanation for the comparatively low benefit program participation among legal immigrants — including those with citizen children — is that some may not apply for benefits due to fears and misconceptions about eligibility rules and the potential for benefit participation to have negative consequences for their immigration status and applications for citizenship.
More broadly, the caseload declines associated with welfare reform have led to increased interest in how program policies and administrative practices affected access to benefits. Various initiatives have since been undertaken to increase low income families' access to medical assistance and, to a lesser extent, food stamps by reducing barriers such as complex application processes, stigma or general lack of awareness concerning eligibility. The enactment of SCHIP in 1997 heightened federal, state, and local efforts to increase access to medical assistance for children through outreach and simplified application processes. To a large degree, these outreach and simplification efforts are credited for bringing about dramatic increases in SCHIP participation since the program's initial implementation and the turnaround in Medicaid caseload declines.
Finally, access issues related to limited English proficiency have also begun to receive greater attention. At the federal level, there have been a series of developments beginning in 2000 with Executive Order 13166, which required each federal agency to issue guidance for improving access to programs and activities funded by that agency for individuals with limited English proficiency. The U.S. Department of Justice subsequently issued complementary guidance to public agencies on how to ensure "meaningful access" for limited English speakers to public programs in 2000, and undertook a formal review of Executive Order 13166 and language access policies issued by all federal agencies during 2001-2002. This process led to issuance of a report on the costs and benefits of the Executive Order (Office of Management and Budget 2002) and final guidance to federal agencies in June 2002 (Department of Justice 2002).