The ability to obtain health care is fundamental to the security, stability, and well-being of poor families. Government-sponsored programs provide temporary support, but as families leave welfare for work, they find themselves without access to coverage or care. The low-wage jobs that individuals in transition are typically able to secure provide few benefits yet often disqualify employees from receiving federal aid. Drawing upon statistical data and in-depth interviews with over five hundred families in Oregon, Karen Seccombe and Kim Hoffman assess the ways in which welfare reform affects the well-being of adults and children who leave the program for work. We hear of asthmatic children whose uninsured but working mothers cannot obtain the preventive medicines to keep them well, and stories of pregnant women receiving little or no prenatal care who end up in emergency rooms with life-threatening conditions. Representative of poor communities nationwide, the vivid stories recounted here illuminate the critical relationship between health insurance coverage and the ability to transition from welfare to work.

Congress must reauthorize the sweeping 1996 welfare reform legislation by October 1, 2002. A number of issues that were prominent in the 1995-96 battle over welfare reform are likely to resurface in the debate over reauthorization. Among those issues are the five-year time limit, provisions to reduce out-of-wedlock births, the adequacy of child care funding, problems with Medicaid and food stamp receipt by working families, and work requirements. Funding levels are also certain to be controversial. Fiscal conservatives will try to lower grant spending levels, while states will seek to maintain them and gain additional discretion in the use of funds. Finally, a movement to encourage states to promote marriage among low-income families is already taking shape. The need for reauthorization presents an opportunity to assess what welfare reform has accomplished and what remains to be done. The New World of Welfare is an attempt to frame the policy debate for reauthorization, and to inform the policy discussion among the states and at the federal level, especially by drawing lessons from research on the effects of welfare reform. In the book, a diverse set of welfare experts—liberal and conservative, academic and nonacademic—engage in rigorous debate on topics ranging from work experience programs, to job availability, to child well-being, to family formation. In order to provide a comprehensive overview of the current state of research on welfare reform, the contributors cover subjects including work and wages, effects of reform on family income and poverty, the politics of conservative welfare reform, sanctions and time limits, financial work incentives for low-wage earners, the use of medicaid and food stamps, welfare-to-work, child support, child care, and welfare reform and immigration. Preparation of the volume was supported by funds from the Annie E. Casey Foundation and the Charles Stewart Mott Foundation.

This collection of 12 essays addresses the issue of welfare reform, providing an overview of welfare reform proposals, the politics and history of reform, and the evidence on the efficacy of past policies. Cloth edition (unseen), $24.95. Annotation copyrighted by Book News, Inc., Portland, OR