Health Care Coverage: Uninsurance -- The Unintended Consequence

One of welfare reform's unintended consequences has been a reduction of health care coverage among poor Americans. The welfare law severed the link between cash assistance and Medicaid. In turn, Congress provided states with several options to continue to offer Medicaid to those leaving welfare and to expand health coverage to more low-income families. Nonetheless, many low-income people lost health care coverage as they moved from welfare to work. This paper provides a statistical portrait of changes in health insurance coverage, and the policy measures that states have taken to fix the problem

Using theories of action to guide national program evaluation and local strategy in the community care network demonstration

Evaluations of multisite community-based projects are notoriously difficult to conceptualize and conduct. Projects may share an overarching vision but operate in varying contexts and pursue different initiatives. One tool that can assist evaluators facing these challenges is to developa theory of action (TOA) that identifies critical assumptions regarding how a program expects to achieve its goals. Community Care Network (CCN) evaluators used the TOA to refine research questions, define key variables, relate questions to each other, and identify when we might realistically expect to observe answers. In this article, the authors present their national-level CCN TOA. They also worked with sites to helpthem surface their local TOA; the article analyzes the results to determine the content, clarity, extent of evidence base, and strategic orientation of theories articulated by different sites