News

A recent study from Portland State University (PSU) found that 40 percent of adults are without health insurance within 18 months of leaving welfare for work, as are 22 percent of children.

Families leaving Temporary Assistance for Needy Families (TANF)—a federal program through Oregon’s Department of Human Services that provides cash assistance to low-income families with children while they strive to become self-sufficient—experience many barriers in securing health care. Many lost eligibility for the Oregon Health Plan (OHP) because they earned amounts just slightly over the program threshold, but did not receive health benefits through an employer and could not afford to purchase them on their own.

This statewide study collected information about health and access to health care in Oregon from a random sample of 637 Oregon families who had left the Temporary Assistance for Needy Families program. Families were interviewed six months after leaving the program and then again one year later, in late 2003, after being off TANF for 18 months, to see how they had fared.

The study found that, after being off TANF for 18 months, 32 percent of study participants reported that someone in their family had delayed seeking needed medical care, and 18 percent had gone without needed medical care altogether during the previous six months. In addition, 40 percent of participants had gone without needed dental care, and 27 percent had failed to fill a needed prescription. These figures represent significant increases from the previous year, when most recipients were still eligible for the Oregon Health Plan.

“Families leaving welfare for work are struggling, and without health insurance many children and their parents were unable to get needed care, causing further illness or injury,” said Karen Seccombe, professor of Community Health at Portland State University and the project’s principal investigator. “Allowing so many working people to be uninsured does not make sense. As residents of Oregon, we can pay now to alleviate their suffering, or we can pay later when they present themselves in emergency rooms, costing us even more.”

For those interviewed, access to the Oregon Health Plan was rated as the most important benefit—even above cash payments—provided through the TANF program; 94 percent of those interviewed identified “health insurance” as being of great importance, because without it, few health care practitioners would see them. Nearly 60 percent of those interviewed reported that they worry whether they will get needed health care.

Ninety respondents to the PSU study were further interviewed in-depth to put a “face” on the startling statistics generated by the study. Their stories revealed the struggles, stress, worry, and coping strategies that low-income families face in trying to provide for their children. Those included:
• “Molly,” who lost her insurance and then suffered silently for weeks until she had to have emergency surgery;
• “Sarah,” who struggles to provide care for her eight-year-old son who has a severe case of cerebral palsy and developmental delays;
• “Guadalupe,” who along with her husband and eight children work hard in the fields of eastern Oregon to make ends meet, yet face the reality that only three of their children are eligible for the Oregon Health Plan;
• “Bob,” who rations his diabetes medication because his wife just lost her employer-sponsored insurance.

The project was funded by the Agency for Healthcare Research and Quality. For more information on the study results, contact Karen Seccombe (seccombek@pdx.edu), PSU School of Community Health, or Kim Hoffman (kimh@pdx.edu), project manager.

Additional Resources:
Agency for Healthcare Research and Quality, www.ahrq.org
Oregon Dept. of Human Services’ Food, Cash and Housing Assistance, www.dhs.state.or.us/assistance/
PSU Center for Public Health Studies, www.cphs.pdx.edu

Source:
Kim Hoffman (503-725-9090; kimh@pdx.edu)
PSU Center for Public Health Studies

For Immediate Release (#05-007)