Medi-Cal After Welfare Reform: Enrollment Among Former Welfare Recipients
Recent studies have concluded that Medicaid enrollment fell over the past several years, both nationally and in California, for people leaving cash welfare. However, this research tends to combine people who have left welfare with other groups of Medicaid enrollees. Using post-welfare reform data from individual administrative records, this research looks directly at the enrollment trends of former welfare recipients to address the question of whether welfare reform has adversely affected their Medi-Cal (California's Medicaid program) enrollment. It finds, in contrast to some observers' fears, that Medi-Cal enrollment after leaving cash aid has actually risen since welfare reform. However, much of this rise resulted from a temporary adminstrative phenomenon that has since ended. In addition, the study finds substantial variation in Medicaid enrollment rates across California's 58 counties, which have sizeable control over the design of their welfare programs. Whether the increase in enrollment rates will cease and whether the variation across counties will stabilize depends largely on the use of recently developed and expanded Medi-Cal programs and on counties' outreach efforts.