Table 8.2 presents coverage more generally, not as it relates to employment status. Respondents were considered to be covered by public health insurance if they reported receiving Medicaid in the month prior to interview or if they were receiving welfare or SSI. They were considered to be covered by private health care if they had accepted their employer's plan or had coverage from another private source.
Site and Program
|Sample Size||Program Group (%)||Control Group (%)||Difference (Impact)||Percentage Change (%)|
Has health care coverage
|Atlanta Labor Force Attachment||1,071||71.0||72.4||-1.4||-1.9|
|Atlanta Human Capital Development||1,146||74.0||72.4||1.6||2.2|
|Grand Rapids Labor Force Attachment||1,097||75.1||77.7||-2.6||-3.3|
|Grand Rapids Human Capital Development||1,109||77.8||77.7||0.1||0.2|
|Riverside Labor Force Attachment||1,219||78.3||80.3||-2.0||-2.5|
|Lacked high school diploma or basic skills||657||82.7||80.0||2.7||3.4|
|Riverside Human Capital Development||778||80.3||80.0||0.3||0.4|
Has public health care coverage
|Atlanta Labor Force Attachment||1,071||46.5||51.7||-5.2*||-10.1|
|Atlanta Human Capital Development||1,146||50.3||51.7||-1.4||-2.7|
|Grand Rapids Labor Force Attachment||1,097||41.2||42.5||-1.2||-2.9|
|Grand Rapids Human Capital Development||1,109||43.2||42.5||0.7||1.7|
|Riverside Labor Force Attachment||1,219||55.8||59.4||-3.6||-6.1|
|Lacked high school diploma or basic skills||657||65.3||66.4||-1.1||-1.7|
|Riverside Human Capital Development||778||63.4||66.4||-3.1||-4.6|
Has private health care coverage
|Atlanta Labor Force Attachment||1,071||28.6||24.1||4.5*||18.5|
|Atlanta Human Capital Development||1,146||27.4||24.1||3.3||13.5|
|Grand Rapids Labor Force Attachment||1,097||41.8||40.7||1.1||2.7|
|Grand Rapids Human Capital Development||1,109||41.3||40.7||0.5||1.3|
|Riverside Labor Force Attachment||1,219||26.9||25.7||1.2||4.7|
|Lacked high school diploma or basic skills||657||20.9||18.0||2.9||16.4|
|Riverside Human Capital Development||778||23.9||18.0||5.9*||33.1|
|SOURCE: MDRC calculations from the Five-Year Client Survey.
NOTES: See Appendix A.2.
As the upper panel of Table 8.2 shows, coverage levels for the control group ranged from 72 percent in Atlanta to 81 percent in Portland, meaning that 20 to 30 percent of respondents were uninsured at the end of year 5. The percentage uninsured is higher than it is for the nation as a whole but lower than it is for low-income individuals. A recent study reported that 16 percent of all adults with children were uninsured; among those with incomes below poverty, 42 percent were uninsured.(9) A later section in this chapter will look more closely at the respondents who no longer had coverage at the time of the survey.
The middle and lower panels of Table 8.2 show that the majority of the coverage is from public sources. In Portland, for example, 80 percent of control group members had any coverage, 47 percent had public coverage, and 38 percent had private coverage. This extent of public coverage makes sense, considering that 20 to 40 percent of sample members were still on welfare at the five-year point and that those who left welfare shortly before that were probably still receiving Transitional Medicaid (data on the take-up of Transitional Medicaid are shown in a later section). In Riverside, for example, nearly 40 percent of control group members were still receiving welfare at the end of year 5, which explains why the extent of public coverage is relatively high in this site. In Portland, the extent of public coverage is also related to Oregon's OHP, since about 20 percent of control group members were receiving welfare at the five-year point.
None of the programs produced a statistically significant impact on coverage (upper panel of Table 8.2). Levels of coverage were about the same for program group members as for control group members. This result is encouraging since the expectation was that many welfare recipients would lose insurance as they went from welfare to work.
The impacts on types of coverage (middle and lower panels of Table 8.2) show that the programs may have led to a shift from public to private sources. Although few of the impacts are statistically significant, the general pattern is that program group members were less likely to have public coverage and more likely to have private coverage than control group members. For the Atlanta LFA program, this shift in coverage is statistically significant; the program reduced public health care coverage by 5 percentage points and increased private coverage by 5 percentage points. This is consistent with the program's moving more welfare recipients to work.