Poor, employed women suffer loss of insurance under welfare reform.

Just as the country embarks on a second wave of welfare reform, a new report has shown poor women suffered an unexpected loss of health insurance under the first decade of the plan.

Many women who successfully moved from welfare to work under the 1996 law wound up losing their Medicaid coverage and thereby being uninsured, according to the report from the Rural Policy Research Institute's Center for Rural Health Policy Analysis.

"One of the unintended consequences of welfare reform is that a substantial percentage of former welfare recipients have lost their Medicaid coverage and became uninsured," said report coauthor Timothy McBride, a professor of public health at St. Louis University and an analyst with the center.

Those who became employed were more likely to be uninsured than were those who remained jobless, the report found. Also, rural residents were more likely than urban residents to lose insurance coverage after leaving welfare.

About 25 percent of rural residents who had been on the AFDC program and insured in 1992-93 had lost their health insurance by 1999, the report found. That compares to 21 percent of similarly situated urban residents.

About 15 percent of the rural and urban poor who had been on AFDC--the old Aid to Families with Dependent Children program--lost their health insurance in that period. Overall, 10 percent of low-income people gained health insurance during this timeframe, the report found.

This finding "suggests that welfare reform was the significant event impacting the loss of insurance coverage for AFDC recipients," the report said. The effects were particularly pronounced for women and single mothers. In rural areas, working low-income women ...