| There is growing concern that one of the unintended consequences of welfare reform is that thousands of families with children are becoming uninsured when they leave the welfare program. Prior research suggests that uninsurance after welfare may jeopardize the health and employment of welfare leavers and increase their likelihood of a return to welfare. Using data from a longitudinal study in Minnesota, this research examines the factors that affect welfare leavers' health insurance status. Unlike prior research that focuses on state program procedures, this research concentrates on individual characteristics and motivations that determine welfare leavers' health coverage using psychologist's expectancy value theory.; Although Minnesota has comprehensive public programs, welfare leavers in Minnesota are at high risk of being uninsured. The uninsured rate among welfare leavers is five times that of the general population. Older welfare leavers, those with lower incomes and those who were familiar with Medicaid eligibility rules were more likely to have Medicaid after leaving the welfare program.; Among employed welfare leavers, those who were aware of Food Stamp eligibility rules, those who had higher rates of health care utilization, and those with full-time, permanent, or professional positions were more likely to be offered employer-sponsored coverage. Among those offered coverage, welfare leavers with higher incomes and those who had been off of welfare for a longer period of time had higher take-up rates.; The findings of significant expectancy value measures suggest that the inclusion of psychological measures in models of health coverage is an important area of study. The high rate of uninsurance among leavers suggests that Minnesota's welfare, Medicaid, and MinnesotaCare programs need to be better coordinated to facilitate access to existing programs. Specific policy recommendations include updating Medicaid eligibility procedures and exploring options to improve welfare clients' access to employer coverage through full-time employment. |
