State of Indiana: Strategies for improving food stamp, Medicaid, and SCHIP participation

The 1996 federal welfare reform law, which sets time limits on benefits and requires increasing numbers of clients to participate in work-related activities, was designed to encourage families to leave cash assistance for work and thereby reduce the welfare rolls. Aware of the possibility that the new legislation might negatively affect access to Medicaid, policymakers enacted Section 1931 to de-link Medicaid from welfare. Nevertheless, Medicaid enrollment has declined at a rate higher than expected since 1996, leading federal and state policymakers to become concerned that enrollment has indeed been affected by changes in cash assistance programs. Similar concerns have been raised in regard to the dramatic drop in participation in the Food Stamp Program. In response to these concerns, the U.S. Departments of Health and Human Services and Agriculture contracted with Mathematica Policy Research, Inc. (MPR) to identify state policies and procedures that appear to promote enrollment in Medicaid and/or the Food Stamp Program in the post-welfare reform era. We selected Indiana as the site for this study because the state increased Medicaid enrollment by almost 15 percent between 1998 and 1999. This report documents the results of our examination of Indiana's efforts to promote enrollment, primarily for children, in Medicaid and SCHIP and to begin to identify strategies for increasing enrollment
in the Food Stamp Program. (author abstract)