National Evaluation of the Welfare-to-Work Grants Program: Final Report. Lack of Health Insurance

09/01/2004

WtW enrollees had more difficulty maintaining health insurance coverage for themselves than for their children. Exhibit V.12 shows near-universal coverage (93 percent or more) by public or private health insurance for the children of WtW enrollees two years after program entry in all but the Ft. Worth (84 percent) and St. Lucie County (89 percent) sites. The coverage rates for children were essentially unchanged from the previous year, as illustrated in the top panel of Exhibit V.14. For the enrollees themselves, the median coverage rate across the study sites was just 75 percent. The enrollee coverage rate was lowest in Milwaukee, where very low rates of TANF receipt (4 percent, as shown in Exhibit V.2) by the noncustodial parent enrollees reduced the likelihood they would be covered by Medicaid (Exhibit V.12). In six sites, the percentage of enrollees covered by health insurance fell during the second year following program entry by between 4 points (Philadelphia) and 12 points (West Virginia), as shown in the bottom panel of Exhibit V.14.

Loss of Medicaid coverage following exit from TANF appears to have been a factor behind the reductions in health insurance coverage for WtW enrollees. In five of the six sites where enrollee health insurance coverage rates fell the second year after program entry, rates of receipt of TANF also fell. A comparison of the bottom panel of Exhibit V.14 with Appendix Exhibit B.12 reveals that rates of health insurance coverage and TANF receipt both fell significantly in Boston, Chicago, Ft. Worth, Philadelphia, and West Virginia. St. Lucie County was the only site where the health insurance coverage rate for WtW enrollees fell but there was no significant reduction in the rate of TANF receipt. Thus, it appears that exit from TANF exposed enrollees in about half of the study sites to a greater risk that they, but not their children, would be without health insurance coverage.(67)

EXHIBIT V.1
PERCENTAGES OF WtW ENROLLEES WHO RECEIVED ASSISTANCE THROUGH SUPPORT NETWORKS
DURING THE SECOND YEAR AFTER PROGRAM ENTRY

EXHIBIT V.1 PERCENTAGES OF WtW ENROLLEES WHO RECEIVED ASSISTANCE THROUGH SUPPORT NETWORKS DURING THE SECOND YEAR AFTER PROGRAM ENTRY.

EXHIBIT V.2
PERCENTAGES OF WtW ENROLLEES WHO WERE RECEIVING TANF OR ANY GOVERNMENT ASSISTANCE
TWO YEARS AFTER PROGRAM ENTRY

EXHIBIT V.2 PERCENTAGES OF WtW ENROLLEES WHO WERE RECEIVING TANF OR ANY GOVERNMENT ASSISTANCE TWO YEARS AFTER PROGRAM ENTRY.

EXHIBIT V.3
TANF AND FOOD STAMP PARTICIPATION RATES BEFORE AND AFTER PROGRAM ENTRY:
EARLY WtW ENROLLEES

EXHIBIT V.3 TANF AND FOOD STAMP PARTICIPATION RATES BEFORE AND AFTER PROGRAM ENTRY: EARLY WtW ENROLLEES.EXHIBIT V.3 TANF AND FOOD STAMP PARTICIPATION RATES BEFORE AND AFTER PROGRAM ENTRY: EARLY WtW ENROLLEES.EXHIBIT V.3 TANF AND FOOD STAMP PARTICIPATION RATES BEFORE AND AFTER PROGRAM ENTRY: EARLY WtW ENROLLEES.EXHIBIT V.3 TANF AND FOOD STAMP PARTICIPATION RATES BEFORE AND AFTER PROGRAM ENTRY: EARLY WtW ENROLLEES.EXHIBIT V.3 TANF AND FOOD STAMP PARTICIPATION RATES BEFORE AND AFTER PROGRAM ENTRY: EARLY WtW ENROLLEES.EXHIBIT V.3 TANF AND FOOD STAMP PARTICIPATION RATES BEFORE AND AFTER PROGRAM ENTRY: EARLY WtW ENROLLEES.EXHIBIT V.3 TANF AND FOOD STAMP PARTICIPATION RATES BEFORE AND AFTER PROGRAM ENTRY: EARLY WtW ENROLLEES.EXHIBIT V.3 TANF AND FOOD STAMP PARTICIPATION RATES BEFORE AND AFTER PROGRAM ENTRY: EARLY WtW ENROLLEES.EXHIBIT V.3 TANF AND FOOD STAMP PARTICIPATION RATES BEFORE AND AFTER PROGRAM ENTRY: EARLY WtW ENROLLEES.EXHIBIT V.3 TANF AND FOOD STAMP PARTICIPATION RATES BEFORE AND AFTER PROGRAM ENTRY: EARLY WtW ENROLLEES.EXHIBIT V.3 TANF AND FOOD STAMP PARTICIPATION RATES BEFORE AND AFTER PROGRAM ENTRY: EARLY WtW ENROLLEES.

EXHIBIT V.3 TANF AND FOOD STAMP PARTICIPATION RATES BEFORE AND AFTER PROGRAM ENTRY: EARLY WtW ENROLLEES.

Data Source: state TANF and food stamp records
Reference: Exhibits D.2.b and D.3.b

EXHIBIT V.4
CHANGES IN THE RECEIPT OF SSI/SSDI AND ANY GOVERNMENT ASSISTANCE
BETWEEN THE FIRST AND SECOND YEARS AFTER PROGRAM ENTRY

EXHIBIT V.4 CHANGES IN THE RECEIPT OF SSI/SSDI AND ANY GOVERNMENT ASSISTANCE   BETWEEN THE FIRST AND SECOND YEARS AFTER PROGRAM ENTRY.

EXHIBIT V.4 CHANGES IN THE RECEIPT OF SSI/SSDI AND ANY GOVERNMENT ASSISTANCE   BETWEEN THE FIRST AND SECOND YEARS AFTER PROGRAM ENTRY.

EXHIBIT V.5
PERCENTAGE DISTRIBUTION OF WtW ENROLLEES BY RECEIPT OF TANF AND EMPLOYMENT
2 YEARS AFTER PROGRAM ENTRY

EXHIBIT V.5 PERCENTAGE DISTRIBUTION OF WtW ENROLLEES BY RECEIPT OF TANF AND  EMPLOYMENT 2 YEARS AFTER PROGRAM ENTRY.

Reference: Exhibit B.14

EXHIBIT V.6
CHANGES IN EMPLOYMENT AND THE RECEIPT OF TANF
BETWEEN THE FIRST AND SECOND YEARS AFTER PROGRAM ENTRY

EXHIBIT V.6 CHANGES IN EMPLOYMENT AND THE RECEIPT OF TANF BETWEEN THE FIRST AND SECOND YEARS AFTER PROGRAM ENTRY.

EXHIBIT V.6 CHANGES IN EMPLOYMENT AND THE RECEIPT OF TANF BETWEEN THE FIRST AND SECOND YEARS AFTER PROGRAM ENTRY.

*/**/*** Change from end of Year 1 to end of Year 2 is statistically significant at the .10/.05/.01 level.
Reference: Exhibit B.15

EXHIBIT V.7
MEAN MONTHLY HOUSEHOLD INCOME OF WtW ENROLLEES,
BY SOURCE, TWO YEARS AFTER PROGRAM ENTRY

EXHIBIT V.7 MEAN MONTHLY HOUSEHOLD INCOME OF WtW ENROLLEES, BY SOURCE, TWO YEARS AFTER PROGRAM ENTRY.

The measures of government assistance and total income include food stamps.
Reference: Exhibit B.16

EXHIBIT V.8
INCIDENCE OF HOUSEHOLD POVERTY AND SEVERE POVERTY AMONG WtW ENROLLEES
TWO YEARS AFTER PROGRAM ENTRY

EXHIBIT V.8 INCIDENCE OF HOUSEHOLD POVERTY AND SEVERE POVERTY AMONG WtW ENROLLEES  TWO YEARS AFTER PROGRAM ENTRY.

Poverty: monthly income less than 100% of federal poverty threshold.
Severe poverty: monthly income less than 50% of federal poverty threshold.
The measure of income does not include food stamps.
Reference: Exhibit B.17

EXHIBIT V.9
INCIDENCE OF HOUSEHOLD POVERTY AMONG WtW ENROLLEES, BY EMPLOYMENT STATUS,
TWO YEARS AFTER PROGRAM ENTRY

EXHIBIT V.9 INCIDENCE OF HOUSEHOLD POVERTY AMONG WtW ENROLLEES, BY EMPLOYMENT STATUS, TWO YEARS AFTER PROGRAM ENTRY.

*/**/*** Difference in household poverty rate between employed and not employed is statistically significant at the .10/.05/.01 level.
Reference: Exhibit B.19

EXHIBIT V.10
INDEX OF MATERIAL DISTRESS EXPERIENCED DURING THE YEAR
BY WtW ENROLLEES AND THEIR HOUSEHOLDS

EXHIBIT V.10 INDEX OF MATERIAL DISTRESS EXPERIENCED DURING THE YEAR BY WtW ENROLLEES AND THEIR HOUSEHOLDS.

EXHIBIT V.10 INDEX OF MATERIAL DISTRESS EXPERIENCED DURING THE YEAR BY WtW ENROLLEES AND THEIR HOUSEHOLDS.

Components of the index: (1) could not pay full rent or mortgage, (2) evicted from home or apartment, (3) could not pay full utility bill, (4) one or more utilities turned off, (5) telephone disconnected.
*/**/*** Change from Year 1 to Year 2 is statistically significant at the .10/.05/.01 level.
Reference: Exhibits B.18 and B.20

EXHIBIT V.11
PERCENTAGES OF WtW ENROLLEES WHO EXPERIENCED EITHER OF TWO FORMS OF HOMELESSNESS
DURING THE SECOND YEAR AFTER PROGRAM ENTRY

Exhibit V.11 PERCENTAGES OF WtW ENROLLEES WHO EXPERIENCED EITHER OF TWO FORMS OF HOMELESSNESSDURING THE SECOND YEAR AFTER PROGRAM ENTRY.

Reference: Exhibit B.18

EXHIBIT V.12
PERCENTAGES OF WtW ENROLLEES AND THEIR CHILDREN WHO WERE COVERED BY HEALTH INSURANCE
TWO YEARS AFTER PROGRAM ENTRY

EXHIBIT V.12 PERCENTAGES OF WtW ENROLLEES AND THEIR CHILDREN WHO WERE COVERED BY HEALTH INSURANCE TWO YEARS AFTER PROGRAM ENTRY.

Reference: Exhibit B.21

EXHIBIT V.13
CHANGES IN HOMELESSNESS AMONG WtW ENROLLEES
BETWEEN THE FIRST AND SECOND YEARS AFTER PROGRAM ENTRY

EXHIBIT V.13 CHANGES IN HOMELESSNESS AMONG WtW ENROLLEES BETWEEN THE FIRST AND SECOND YEARS AFTER PROGRAM ENTRY.

EXHIBIT V.13 CHANGES IN HOMELESSNESS AMONG WtW ENROLLEES BETWEEN THE FIRST AND SECOND YEARS AFTER PROGRAM ENTRY.

*/**/*** Change from Year 1 to Year 2 is statistically significant at the .10/.05/.01 level.
Reference: Exhibit B.22

EXHIBIT V.14
CHANGES IN HEALTH INSURANCE COVERAGE AMONG WtW ENROLLEES AND THEIR CHILDREN
BETWEEN THE FIRST AND SECOND YEARS AFTER PROGRAM ENTRY

EXHIBIT V.14 CHANGES IN HEALTH INSURANCE COVERAGE AMONG WtW ENROLLEES AND THEIR CHILDREN BETWEEN THE FIRST AND SECOND YEARS AFTER PROGRAM ENTRY.

EXHIBIT V.14 CHANGES IN HEALTH INSURANCE COVERAGE AMONG WtW ENROLLEES AND THEIR CHILDREN BETWEEN THE FIRST AND SECOND YEARS AFTER PROGRAM ENTRY.

*/**/*** Change from Year 1 to Year 2 is statistically significant at the .10/.05/.01 level.
Reference: Exhibit B.22

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