Medicaid churning--the constant exit and reentry of beneficiaries as their eligibility changes--has long been a problem for both Medicaid administrators and recipients. Churning will continue under the Affordable Care Act because, despite new federal rules, Medicaid eligibility will continue to be based on current monthly income. We developed a longitudinal simulation model to evaluate four policy options for modifying or extending Medicaid eligibility to reduce churning.
View Article and Find Full Text PDFChanges in individual or family circumstances cause many Americans to experience gaps and transitions in public and private health insurance. Using data from the 2004-2007 Survey of Income and Program Participation, this article updates earlier analyses of insurance gaps and transitions. Eighty-nine million people (one third of nonelderly Americans) were uninsured for at least 1 month during those 4 years.
View Article and Find Full Text PDFThe thesis of this study is that as a result of increased inequalities in welfare rules, the 1996 welfare reform act not only enhanced incentives for poor families to move but also (and perhaps more important) created disincentives for them to stay in "race to the bottom" states. In testing this thesis, we evaluated the mediating and moderating roles of state economic development and family structure. We merged data from three main sources: the 1996-1999 panel of the Survey of Income and Program Participation, the Urban Institute's Welfare Rules Database, and state economic data from the Bureau of Labor Statistics.
View Article and Find Full Text PDFHealth Aff (Millwood)
March 2004
This study assesses the stability of Americans' health insurance status over a four-year period. Relatively few Americans were continuously uninsured for the four years 1996 to 1999, but a sizable number of the uninsured lacked a stable source of coverage. At least as many people were repeatedly uninsured as experienced a single gap in otherwise stable coverage.
View Article and Find Full Text PDFIssue Brief (Commonw Fund)
November 2003
Perspect Sex Reprod Health
May 2003
Context: Much of the debate over welfare reauthorization centers on whether marriage promotion should play a key role. Few studies, however, have tracked the marriage and divorce histories of unwed mothers, including minority women, who are often the main targets of welfare reform.
Methods: Data from the 1995 National Survey of Family Growth were used to estimate the hazards of the transition to marriage for women who delayed childbearing until marriage and for teenagers and older women who had a nonmarital first birth, and of the transition to divorce among the ever-married.