Status Report on Research on the Outcomes of Welfare Reform, 2001. Program Participation

08/17/2001

Returns to TANF

According to data from 15 studies, between 3 and 21 percent of families leaving welfare returned to cash assistance within one quarter (see Table 4). Rates of welfare receipt rose to between 9 and 24 percent in the next quarter. Rates rose very slightly over the next six months, reaching 11 to 25 percent one year after exit. Because some people return to the rolls and then leave again, the proportion that ever returned within the first year after exit was higher, ranging from 17 to 38 percent.(6)

 

Table 4.
Percentage of Adult Leavers Receiving AFDC/TANF
Grantee & Cohort CY(Qtr) Administrative Data:
AFDC/TANF Receipt
1st Qtr (3 mos) post exit 2nd Qtr (6 mos) post exit 3rd Qtr (9 mos) post exit 4th Qtr (12 mos) post exit Ever receiving within 1 yr
Arizona 98(4) 5.3 12.9 16.6 15.5 27.7
Florida 97(2) 6.5 13.9 12.8 -- 26.1
Georgia 99(1) 8.4 14.4 16.4 16.0 --
Illinois 97(2)-98(4) 16.2 18.6 17.5 16.3 28.9
Iowa 99(2) 5.5 14.2 19.0 18.8 30.1
Massachusetts 9(1)* 2.9 10.0 14.3 11.4 18.8
Missouri 96(4)* 12.4 18.6 20.8 20.6 --
New York 97(1) -- -- -- 17.0 --
S. C. 99(4)-00(1) 3.4 8.8 11.7 10.9 17.1
Washington 97(4) 8.0 14.0 16.0 16.0 --
Wisconsin 98(2)-(4)* 18.5 22.1 21.8 19.7 35.5
D.C. 98(4)* 7.5 12.7 16.2 18.8 21.1
Cuyahoga 98(3) 21.1 24.3 25.5 24.9 38.1
San Mateo 98(4) 16.9 20.9 22.8 20.8 --
Notes: Grantees measuring program participation by month — Arizona, Florida, Illinois, Iowa, New York, the District of Columbia, and San Mateo — are likely to report lower program participation than grantees measuring participation over a three-month quarter. These and other methodological differences have a particularly strong effect on measurement of TANF receipt three months/one quarter after exit, and so differences in the first column of Table 3 should be viewed with caution.
* Figures are for single-parent leavers, except that Massachusetts, Missouri, Wisconsin, and the District of Columbia include small percentages of two-parent leavers.

Survey data on returns to TANF are fairly similar to the administrative data. In addition, survey data also found that at least one half of those who returned to TANF did so for a job-related reason, such as job loss or decreases in work hours or wages. Other common reasons for returning to TANF included divorce or separation from partner, pregnancy or birth of a new child, re-compliance with program regulations, loss of other income, problems with child care, and problems with health or medical benefits.

Comparisons of early and later cohorts reveal no clear pattern of returns to welfare (data not shown). As compared with earlier cohorts, recidivism among 1998 leavers was higher in three states but lower in three others. No trend was apparent in two others.

Families leaving in the 1996 to 1999 period did so before they hit the five-year federal time limits on benefit receipt. Thus, most families had the option of returning to cash assistance as needed. Two studies, however, examined cohorts of 1999 leavers who were affected by state time limits of two years. Recidivism rates in these two states — Massachusetts and South Carolina — were lower than rates in other states, as shown in Table 4. Sub-group analysis in these two states indicates that families who left because of time limits were much less likely to be back on welfare at time of interview than other families; only 2 percent of the time-limited families in South Carolina and 8 percent in Massachusetts were back on welfare a year after exit.

Medicaid and Health Insurance

Although the majority of leavers remained off cash assistance, most continued to receive other government support. One of the most common supports was Medicaid, although rates of participation varied considerably across states. As shown in Table 5, between 42 and 80 percent of adult leavers were enrolled in Medicaid in the first quarter post-exit according to administrative data. In many areas, adult enrollment rates dropped 10 percentage points or more by the fourth quarter after exit. Medicaid coverage varied even more dramatically in survey data, ranging from 33 percent in Missouri (measured over 2 years after exit) to 81 percent in Massachusetts (measured slightly under a year after exit). A higher percentage of surveyed leavers — 51 to 83 percent — reported Medicaid coverage for their children, as shown in Table 6.

 

Table 5.
Adult Health Insurance Status
Grantee & Cohort CY(Qtr) Administrative Data: Medicaid Enrollment Survey Data:
Health Insurance Coverage at Interview
1st Qtr post exit 4th Qtr post exit Medicaid Employer Sponsored Insurance Other Insurance No Insurance
Arizona 98(1)** 54 40 39 15 5 40
Georgia99(1)-00(1) -- -- 66 -- -- 24
Florida 97(2) 55 46 -- -- -- 45
Illinois 97(3)-98(4)* 58 40 47 *** 21 36
Iowa 99(2) 43 41 48 14 7 37
Massachusetts 9(1)* -- -- 81 -- -- 7
Missouri 96(4)* 42 39 33 25 9 32
New York 97(1) -- 35 -- -- -- --
S. C. 98(4)-99(1) 69 45 -- -- -- --
Washington 98(4)* 60 -- 56 13 8 26
Wisconsin 98(2)-(4)* 80 76 -- -- -- --
D.C. 98(4)* -- -- 54 19 4 22
Cuyahoga 98(3) 60 46 -- -- -- --
Notes: These rates measure enrollment of the adult head who left TANF. Measures of participation by month - reported by Arizona, Florida, Illinois, Iowa, New York, and the District of Columbia - are likely to be lower than measures of participation over a three-month quarter.
* Rates are for single-parent leavers, except that Illinois, Massachusetts, Missouri, Washington (administrative data), Wisconsin, and D.C. include small percentages of two-parent leavers and Washington tracks the Medicaid enrollment of both adults, not just the adult head.
** Arizona data include leavers who return to TANF after one month, as well as the traditional two-month leavers.
*** Rates for employer-sponsored insurance in Illinois are included in "other."

 

Table 6.
Child Health Insurance Status
Grantee & Cohort CY(Qtr) Administrative Data: Medicaid Enrollment Survey Data:
Health Insurance Coverage at Interview
1st Qtr post exit 4th Qtr post exit Medicaid Employer Sponsored Insurance Other Insurance No Insurance
Arizona 98(1)** -- -- 51 12 8 26
Georgia 99(1)-00(1) -- -- 82 4 3 11
Florida 97(2) -- -- 57 -- -- 33
Illinois 97(3)-98(4)* -- -- 53 *** 23 29
Iowa 99(2) 56 55 63 11 17 20
Massachusetts 99(1)* -- -- 83 -- -- 8
Missouri 96(4)* 85 86 68 14 9 11
New York 97(1) -- 34 -- -- -- --
S. C. 98(4)-99(1) 88 68 85 -- -- --
Washington 98(4) -- -- 67 9 11 13
Wisconsin 98(2)-(4) 86 80 -- -- -- --
D.C. 98(4)* 42 48 60 12 11 16
San Mateo 98(4) 76 59 64 -- 28 9
Notes: These rates are the percentage of adult leavers with at least one child on Medicaid (or one member of a family, in Iowa, D. C. and San Mateo). SCHIP is counted as Medicaid in most surveys. As noted in Table 4, above, measures of participation by month - reported by Arizona, Florida, Illinois, Iowa, New York, the District of Columbia, and San Mateo - are likely to be lower than measures of participation over a three-month quarter.
* Rates are for single-parent leavers, except that Illinois, Massachusetts, Missouri, and D.C. include small percentages of two-parent leavers.
** Arizona data include leavers who return to TANF after one month, as well as the traditional two-month leavers.
*** Rates for employer-sponsored insurance in Illinois are included in "other."

Lack of Medicaid enrollment is not necessarily a problem if leavers have health insurance through employment or other means. However, only 20 to 34 percent of adult leavers reported being covered by employer-sponsored or other insurance; somewhat fewer (7 to 28 percent) reported such coverage for their children. These figures reveal that, in most states, substantial numbers of former recipients and their children were without any health insurance. The percentage of adult leavers without insurance ranged from 7 to 45 percent; rates for children ranged from 8 to 33 percent, for Massachusetts and Florida, respectively. Data in Tables 5 and 6 indicate that lack of health insurance was more prevalent in states with low numbers of leavers enrolled in Medicaid. Survey data from six states (discussed in the section on Material Hardship and displayed in Table 10 below) show the consequences of lack of health insurance coverage.

Some of the state variation in Medicaid enrollment can be explained by differences in survey methodology (e.g., timing and wording of surveys) or in the linking and analysis of administrative data.(7) Still, the observed cross-state variation is too wide to be solely attributable to measurement differences. Some variation in enrollment is likely to reflect differences in Medicaid eligibility (which is set by states) and in administrative practices, which vary across states and local areas.

Findings from the leavers studies and other research have prompted Federal and state initiatives to ensure that families leaving welfare are not incorrectly denied Medicaid benefits. In their leavers reports, several states mentioned changes in policies or procedures designed to increase Medicaid enrollment among future leaver cohorts. Early trends, between 1996 and 1998, show increased Medicaid enrollment in three jurisdictions, no change in one, and decreased enrollment in another.

Food Stamps and Other Program Participation

Participation in other forms of government assistance was also common, though generally at lower levels than for Medicaid. Participation rates of former recipients in the Food Stamp program, for example, ranged from 23 to 78 percent across 12 studies, with most finding that roughly one-third to one-half of AFDC/TANF leavers received food stamps immediately after exit (see Table 7). Similar rates were found in both administrative and survey data. Food stamp receipt declined in some states over time, but remained constant in others.

 

Table 7.
Percentage of Leavers Receiving Food Stamps
Grantee & Cohort CY(Qtr) Administrative Data: Food Stamp Receipt
1st Qtr (3 mos) post exit 2nd Qtr (6 mos) post exit 3rd Qtr (9 mos) post exit 4th Qtr (12 mos) post exit Ever receiving within 1 yr
Arizona 98(1) 39 39 38 35 67
Florida 97(2) 45 41 38    
Illinois 7/97-12/98 33 35 34 33 56
Iowa 99(2) 36 37 38 37 65
Massachusetts 99(1)* 42 41 41 38 51
Missouri 96(4)* 57 47 43 40 --
New York 97(1) -- -- -- 21 --
S. C. 99(4)-00(1) 78 68 64 61 88
Washington 97(4)* 47 42 -- -- --
Wisconsin 98(2)-(4)* 70 68 65 63 83
D.C. 98(4)* 36 38 37 38 41
Cuyahoga 98(3) 56 48 48 47 68
San Mateo 98(4) 23 28 29 27 -
Notes: Grantees measuring program participation by month - Arizona, Florida, Illinois, Iowa, New York, the District of Columbia, and San Mateo - are likely to report lower program participation than grantees measuring participation over a three-month quarter.
* Rates are for single-parent leavers, except that Massachusetts, Missouri, Washington, Wisconsin, and D.C. include small percentages of two-parent leavers.

Other commonly received forms of government assistance included free- and reduced-price school lunches (43 to 87 percent of leavers), the federal Earned Income Tax Credit (32 to 65 percent of former recipients), housing assistance (16 to 60 percent of leavers), and Supplemental Security Income (2 to 12 percent of leavers), according to survey data from several surveys (data not shown). In addition between 11 and 35 percent of former recipients across seven studies reported receiving child support, often secured with help from the child support enforcement agency. As seen below, income from these sources can be an important component of household income.