Health Services Research - Welfare reform and health insuran

The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) changed legal immigrants'' access to public Health Insurance in two ways: directly, by denying Medicaid benefits to immigrants who arrived in the U.S. after August 1996, and indirectly, by denying or limiting immigrant participation in Temporary Aid to Needy Families (TANF), which is an important entry point into Medicaid. An explicit objective of Federal law was to restrict immigrant use of means-tested programs. However, many state governments responded to the immigrant provisions in PRWORA by creating substitute means-tested programs for those immigrants who were adversely affected by the Federal policy.