This proposal requests funds to examine the effects of welfare reform on the access to health insurance and use of health services among former welfare recipients and their children in the state of Oregon, a state with a unique health care financing system. Specifically it will aim to determine how families leaving welfare for employment plan for and cope with the expiration of their one-year transitional OHP/Medicaid coverage, and what happens to them after losing their eligibility for the single year of transitional coverage. The research has two main aims, requiring both quantitative and qualitative strategies: (1) An assessment of the ways in which welfare reform has impacted the health and well-being of Temporary Assistance for Needy Families (TANF) leavers, including (a) access and barriers they face in securing health care; (b) ways in which they utilize the health care system; (c) how these patterns vary by urban and rural residence, and race/ethnicity; and (d) how the Oregon Health Plan (OHP) influences these outcomes. (2) An appraisal of the ways in which families leaving welfare for employment plan for and cope with the expiration of their one-year transitional OHP/Medicaid coverage, including (a) respondents' knowledge, expectations, and planning process for securing health insurance; (b) their worries and coping strategies; (c) an elaboration of the ways in which welfare reform has impacted their health and well-being, the access and barriers they face in securing health care, and the ways they utilize the health care system; and (d) the ways that residential location and race/ethnicity may influence their access and use of services.
