Reformed to Death: More On the Catastrophic Success of Welfare Reform

Terrance Heath

When Paul Ryan first introduced his first “Path to Prosperity” budget proposal, he framed it as an attempt to build upon the “successful” welfare reform of the late 1990s. At the time, I wrote that “welfare reform” was a “catastrophic success,” because of its devastating impact on the people reform advocates claimed reform would help.

I stand by that assessment, but it turns out I got one detail wrong.

At the time I wrote that welfare reform did not reduce the number of people in need of help, but merely reduced the number of people receiving help.

I’m increasingly convinced that most of the time – whether it’s jobs, the economy, or health care – progressives and conservatives are almost never talking about the same thing. If you’re a progressive, all of the above is evidence of that conservative welfare reform was a failure and a fraud, because it didn’t leave families better off because of it. If you’re a conservative, welfare reform was a success because it reduced the number of people on welfare – and that’s all it was supposed to do. It was supposed to get people off welfare rolls. Period. After that, they were on their own.

Paul Ryan, in his WSJ op-ed, says that with his roadmap we “strengthen and improve welfare programs for those who need them, we eliminate welfare for those who don’t.” It’s curious, because it really does sound like he wants to duplicate the catastrophic success of the welfare reform of the 1990s. The “success” was getting people off welfare rolls, not necessarily improving their condition. It was about reducing the number of people receiving government assistance, not reducing the need for assistance. Simply put, it’s fewer people getting help, instead of fewer people needing help.

What makes it a success is also what makes it catastrophic; at least for the people fall from the welfare rolls. Getting people off welfare rolls isn’t a good measure of success, because it fails to ask what they fall into. If the answer is “they go to work,” the next question is whether they go to work that pays them a livable wage, and whether they go to work that gives them an opportunity to improve their economic status, rather than just barely get by. That’s success.

According to a new study, welfare reform actually did reduce the number of people needing help – by shortening their lives.

… The average number of people receiving cash benefits from Temporary Assistance for Needy Families (TANF), the name welfare has gone by since 1996, has fallen from 12.6 million that year to 4.6 million in 2011. “Caseloads declined by 54 percent. Sixty percent of mothers who left welfare found work, far surpassing predictions of experts,” President Clinton wrote in a 2006 op-ed in the New York Times. “Child poverty dropped to 16.2 percent in 2000, the lowest rate since 1979, and in 2000, the percentage of Americans on welfare reached its lowest level in four decades.”

But it’s not that simple. Indeed, the health consequences of the change, a new study suggests, are potentially quite large, and quite negative. The Health Affairs study, written by Columbia’s Peter Muennig and Zohn Rosen, along with the Wallace Foundation’s Elizabeth Ty Wilde, finds that welfare reform increases mortality among recipients, reducing life expectancy by about nine months.

Wonkblog’s Dylan Matthew’s points out that the study doesn’t look at the 1996 reform act itself, but a Florida precursor program that ran from 1994 to 1999. The study found that people in the “welfare to work” program were more likely to find employment than those in traditional welfare, but weren’t likely to have more total income. They also weren’t likely to live as long.

Of the 1,611 experiment participants in the county the study focused on, 75 died by November 2011. Of the 1,613 members of the control group, by contrast, 67 died by November 2011. That means the welfare-to-work had 16 percent higher mortality than those receiving normal cash assistance, a result that was highly statistically significant and, because of the study’s random design, can be attributed to the different welfare program. That amounts to a nine-month reduction in life expectancy between the ages of 30 and 70.

Matthews adds that, since the Florida program was even less stringent than the federal law, it wouldn’t be surprising if the same were true of the national welfare reform. The increase of households in extreme poverty after welfare reform hurt health outcomes, and would have made increases in mortality all but inevitable.

So, it looks like I was wrong. I said that welfare reform didn’t reduce the number of people in need of help, but ensured that fewer people received help. Now it appears that welfare reform did reduce the number of people in need of help, by shortening their lives. Dead people don’t need welfare, after all.

I stand corrected, but only on that one point. A policy that has the effect of shortening lives doesn’t count as a “success.” It’s still a “catastrophic success.”

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