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WHAT IS CHANGING IN HEALTH AND SOCIAL WELFARE PROGRAMS? 4 What Is Changing In Health And Social Welfare Programs? This section provides an overview of recent changes to health and social welfare systems in the United States, focusing on legislative provisions that affect data collection and statistical reporting. Legislative changes have direct implications for data that are needed to track programs. More broadly there are also needs for data to track and help assess the interaction of economic trends and changes in private-sector sources of income and benefits (e.g., employer health and pension benefits) with changes in government programs, although this was not considered explicitly at the workshop. The most important new legislation is PRWORA, which not only gives states increased discretion in defining eligibility rules and benefits under the TANF block grant that replaces AFDC, but also affects SSI, food stamps, Medicaid, benefits for legal immigrants, child care, and the Child Support Enforcement Program. (For additional details on PRWORA, see Appendix B.) TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK GRANT By replacing AFDC with the TANF block grant to states, PRWORA eliminates the longstanding federal entitlement of families with dependent children to cash assistance, and it gives states broad powers to develop social service programs for specific population groups and not others.1 For instance, states can refuse assistance to teenage parents, two-parent families, and noncitizen families, and limit assistance to families who have migrated from other states. States may also reduce or eliminate cash benefits, relying instead on such alternatives as in-kind transfers, services to families, or wage supplements for employers. While PRWORA gives states broad powers to experiment with welfare programs, there are a number of strict limits imposed on the length of time adults can receive unconditional assistance from programs funded by the TANF grant. In particular, there is a 2-year limit, after which adult recipients are required to participate in work activities in order to receive assistance, and a 5-year limit, after which adult recipients are ineligible for assistance from programs funded by the TANF grant. 1 States had until July 1, 1997, to submit a state plan and begin implementing the TANF block grant.