ABSTRACT
This chapter discusses the current politics of welfare reform and link welfare reform to current efforts to reform health care. It focuses on state efforts in Aid to Families with Dependent Children (AFDC) spending, describes changes between 1980 and 1990 and estimating ordinary least squares models to explain variations in state efforts in the two time periods. The chapter tests three popular explanations for state efforts in AFDC spending—politics, economics, and as a reaction to runaway Medicaid spending. The results may be helpful in anticipating the effects of recent reforms that replaced AFDC, an entitlement program, with Temporary Assistance to Needy Families (TANF) in the form of block grants to states. Given the spending trends for welfare and health care differed markedly in the 1980s, one might expect their priorities on the reform agenda to differ substantially. However, they are closely linked, particularly in the area of welfare medicine, where state and county governments are especially active given their responsibilities.
