6. Summary
The 1996 welfare reform legislation contained a number of provisions that greatly limited
the eligibility of many immigrants (particularly non-citizens and non-refugees) to receive
many types of public assistance. In response to the federal legislation, many states chose
to protect their immigrant populations from the presumed adverse impact of PRWORA by
offering state-funded assistance to these groups.
I use data drawn from 1995 to 2001 Annual Demographic Supplements of the Current
Population Surveys to examine the relation between the immigrant-related provisions in
PRWORA—as modified by the subsequent state responses—and health insurance coverage
in the immigrant population. In the absence of any behavioral response, one would have
expected that health insurance coverage rates would have been sharply curtailed in the
population most adversely affected by the restrictions, the non-citizens living in states that
did not offer state-funded assistance to their immigrant populations. In other words, as the
Medicaid cutbacks took effect, the proportion of those immigrants covered by some type
of health insurance should have declined.
The empirical analysis indeed indicates that the targeted immigrant population experienced
a decline in Medicaid coverage as the PRWORA provisions took effect. However,
the analysis also reveals that the expected decline in health insurance coverage rates did not
materialize. If anything, health insurance coverage rates actually rose slightly in this group.
The resolution to this conflicting evidence lies in the fact that the affected immigrants responded
to the welfare cutbacks. The immigrants most likely to be adversely affected by the
6. SummaryThe 1996 welfare reform legislation contained a number of provisions that greatly limitedthe eligibility of many immigrants (particularly non-citizens and non-refugees) to receivemany types of public assistance. In response to the federal legislation, many states choseto protect their immigrant populations from the presumed adverse impact of PRWORA byoffering state-funded assistance to these groups.I use data drawn from 1995 to 2001 Annual Demographic Supplements of the CurrentPopulation Surveys to examine the relation between the immigrant-related provisions inPRWORA—as modified by the subsequent state responses—and health insurance coveragein the immigrant population. In the absence of any behavioral response, one would haveexpected that health insurance coverage rates would have been sharply curtailed in thepopulation most adversely affected by the restrictions, the non-citizens living in states thatdid not offer state-funded assistance to their immigrant populations. In other words, as theMedicaid cutbacks took effect, the proportion of those immigrants covered by some typeof health insurance should have declined.The empirical analysis indeed indicates that the targeted immigrant population experienceda decline in Medicaid coverage as the PRWORA provisions took effect. However,the analysis also reveals that the expected decline in health insurance coverage rates did notmaterialize. If anything, health insurance coverage rates actually rose slightly in this group.The resolution to this conflicting evidence lies in the fact that the affected immigrants respondedto the welfare cutbacks. The immigrants most likely to be adversely affected by the
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