Traci Holmes
May 29th, 2011
HCR 230
Week 3
The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) enacted in 1996 set forth three legislative goals: 1) to reduce dependence; 2) to reduce child poverty; and 3) to reduce illegitimacy and strengthen marriage. The reform has been effective in meeting each of these goals. ( Robert Rector)
While the welfare reform law did not change how Medicaid delivers health care nor alter its
entitlement status, it reduces the number of people covered and lowers federal expenditures.
Medicaid is the joint federal-state health insurance program for low-income families, senior
citizens, and people with …show more content…
These
savings will lower the federal deficit and reduce the pressure for further Medicaid spending
cuts. (Leighton Ku, Theresa A. Coughlin)
This policy brief discusses the four principal changes made to Medicaid eligibility by the welfare reform legislation: * Decoupling welfare and Medicaid eligibility; * Narrowing Medicaid eligibility for disabled children in the Supplemental Security Income (SSI) program; * Terminating access to Medicaid for some legal immigrants because they lose SSI; and * Barring most future legal immigrants from Medicaid. (Leighton Ku, Theresa A. Coughlin)
The new legislation ends the use of individual assessments; children now must
demonstrate one of the "listed" medical impairments to qualify for SSI benefits. The Social
Security Administration estimates 135,000 children will lose SSI grants because of these
changes. However, most of these children (an estimated 80 percent) will still be eligible for
Medicaid through other criteria, such as those for children under the poverty level. …show more content…
Policies for immigrants who were in the United States when the law was passed
differ from policies for those who arrive in the future. In addition, the new legislation permits
states to exclude current noncitizen immigrants from all but emergency Medicaid services,
regardless of their categorical need or income. However, we are not aware of any states that
are currently planning to exercise this option. If any state implemented such a provision,
current immigrants would be much more strongly affected. (Leighton Ku, Theresa A.
Coughlin)
For most health care providers, welfare reform will have modest effects. Medicaid's
entitlement nature and the form of health care delivery is not altered by the new legislation.
"Safety net providers" (hospitals and clinics that serve a large number of Medicaid and
uninsured patients) will face more serious consequences. Safety net providers include public
and nonprofit hospitals, community health centers, and related public and charitable facilities
that offer free or reduced-price medical care to the poor and uninsured. The most strongly
affected will be hospitals and clinics located in high-immigrant areas. (Leighton Ku,