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September 2002, Vol 92, No. 9 | American Journal of Public Health 1441-1445
© 2002 American Public Health Association

FORUM ON WELFARE REFORM

Changes in Use of Health Insurance and Food Assistance Programs in Medically Underserved Communities in the Era of Welfare Reform: An Urban Study

Susmita Pati, MD, MPH, Diana Romero, PhD, MA and Wendy Chavkin, MD, MPH

Susmita Pati is with the Departments of General Pediatrics and General Medicine, Columbia University College of Physicians and Surgeons, New York City. Diana Romero and Wendy Chavkin are with the Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City.

Correspondence: Requests for reprints should be sent to Susmita Pati, MD, MPH, Division of General Medicine, 622 West 168th St, PH 9 East, Room 105, New York, NY 10032 (e-mail: sp293{at}columbia.edu).

Objectives. The purpose of this study was to assess changes in health insurance and food assistance enrollment following passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996.

Methods. Extant data sources were used to calculate changes in Temporary Assistance for Needy Families (TANF), Medicaid, and Food Stamp program enrollment in medically underserved Manhattan communities after 1996.

Results. Dramatic declines in TANF enrollment were accompanied by declines in Food Stamp program enrollment and a deceleration in Medicaid enrollment among several communities.

Conclusions. As the Personal Responsibility and Work Opportunity Reconciliation Act comes up for reauthorization later in 2002, policymakers should revise legislation so that needy families do not lose health insurance or food assistance support.




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