Minimizing Adverse Public Health Consequences of the 1996 Welfare Reform Act

[摘要]

The American Public Health Association,

Recognizing the President has signed into law PL 104-193 (Personal Responsibility and Work Opportunity Act of 1996) which eliminates certain categorical entitlements for at-risk children and families; and

Noting that the American Public Health Association has a long-standing policy of support and advocacy for the best health interests of women and children in the United States; and

Noting that family planning services are central to the health and well-being of people, and the long-standing federal entitlement to voluntary family planning services under AFDC (Aid to Families with Dependent Children) was lost in the transition from AFDC to TANF (Temporary Assistance to Needy Families);

Realizing that significant numbers of currently eligible beneficiaries have limited literacy capabilities and inadequate job skills to assure employment without additional training;¹ and

Noting that family planning services are central to the health and well-being of people, and the long-standing federal entitlement to voluntary family planning services under AFDC was lost in the transition from AFDC to TANF; and

Recognizing that the majority of currently eligible beneficiaries are women with children,² who will not have adequate financial resources for child care;¹ therefore

Urges the President and Congress to repeal the law or to amend it to assure that there are no adverse public health, social, or economic effects from the implementation of the law;

Urges that education and training opportunities and jobs with a living wage be guaranteed before eligibility for Temporary Assistance to Needy Families (TANF) is denied;

Urges that outpatient substance abuse treatment and inpatient (residential) detoxification services be made available for at least one medically appropriate comprehensive treatment opportunity before eligibility is denied due to identified substance abuse;

Urges that all recipients be screened by appropriately trained personnel for physical and sexual abuse and offered access to comprehensive services (i.e. counseling, shelter, etc.) and further urges that abuse victims be exempted from the two-year consecutive and five-year lifetime caps for TANF support;

Urges that voluntary and free family planning services be guaranteed to all welfare recipients and to any former recipient for a period of at least two years after losing his/her eligibility for welfare, and that Congress appropriate such additional funds as necessary for this purpose;

Urges that sufficient, high quality, accessible, and affordable child care services be made available for any beneficiary who is required to attend training or to work to obtain benefits;

Urges that health benefits for the individual and his/her dependents be provided as an integral component of any employment, including part-time or temporary, that arises from this initiative;

Urges that any implementation of the 1996 Welfare Reform Act or any new legislation result in no loss of benefits, access, or range of services to those currently eligible for Medicaid, and further urges that states and counties take action to assure continuation of Medicaid coverage for recipients and children who remain eligible;

Urges that the federal and state governments collect and monitor data on the consequences of reduced welfare benefits; and

Urges states to adopt these policies and guidelines.

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References

1. The Twentieth Century Fund. Welfare Reform: A Twentieth Century Fund Guide to the Issues. New York, NY: Twentieth Century Fund Press, 1995.
2. US Congress, House Committee on Ways and Means. Overview of Entitlement Programs, 1994 Green Book. Washington, DC: US Government Printing Office, 1994.

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[发布日期] 1997-01-01

[学科分类] 医学（综合）