Welfare Reform and Indirect Impacts on Health

The stated goals of welfare reform are to increase work, reduce dependency on welfare, reduce births outside marriage, and to increase the formation of two parent families. However, welfare reform may also have indirect impacts on health. We provide a comprehensive review of the literature on the impacts of welfare reform on health. We illustrate the main findings from the literature by presenting estimates of the impact of reform on health insurance, health utilization, and health status using data from five state waiver experiments. The most consistent finding is that welfare reform led to a reduction in health insurance coverage. The impacts on health care utilization and health status tend to be more mixed and fewer are statistically significant. While the results are not conclusive, they suggest that welfare-to-work programs need not have large negative health effects.