Final Synthesis Report of Findings from ASPE "Leavers" Grants. Health Care Related Problems


In Chapter IV, we discussed the high percentage of adult leavers that do not have health insurance coverage. Lack of health insurance, out-of-pocket costs, and difficulty accessing medical providers even when insured can leave families unable to obtain needed medical care. Six studies report some measure of leaver families having problems affording or receiving health care (Table VI.5).

Table VI.5:
Single-Parent Leavers' Experience of Material Hardship: Problems Receiving Health Care, Comparison Before and After Exit from TANF


AZ DC1 GA IL1 SC1,2 Cuyahoga Co.
Pre Post Pre Post   Pre Post Pre Post  

Could not afford health care

14 24 3 8            

Didn't get medical attention when needed

        10 26 31 4 10 40

Didn't go to dentist when needed

        16         41

1Results are for all cases, not just single-parents.
2Results are for families that remain off of welfare at the time of the survey.
Source: SeeAppendix B for a complete listing of the leavers studies referenced.

>Two studies report the percentage of leaver families that are unable to afford health care8 percent of families in DC and 24 percent in Arizona. The percentage of leaver families reporting they didnt seek medical attention when needed because of costs also varies, from 10 percent in Georgia and South Carolina to 40 percent in Cuyahoga County. The variation in these reports may be related to the percentage who report themselves as uninsured in each study. South Carolina and DC report the lowest rates of adult uninsurance among these studies.

In all four studies that report pre- and post-exit health care problems the incidence of problems is higher after exiting welfare. For example, in Arizona 14 percent of leaver families could not afford health care before exiting TANF, but 24 percent report this problem after exit. These results are consistent with the significant declines in Medicaid coverage among leavers in Arizona reported in Chapter IV. Interestingly, in three of these studies, Arizona, DC, and Illinois, the incidence of food and housing problems reported by leaver families was generally lower after exit compared with while on TANF.