Analysis of Food Stamp and Medical Assistance Caseload Reductions in Milwaukee County: 1995-1999 (Part Four)

University of Wisconsin-Milwaukee Employment and Training Institute, January 2000

V.    Follow-Up of Cases Receiving Food Stamps in December 1995

The December 1995 population was tracked over time to assess subsequent AFDC/W-2, food stamp and medical assistance status for selected months through September 1999. Subgroups were also defined for 1) the AFDC population (not in group 3 below) receiving food stamps, 2) the population of families receiving only food stamps, 3) AFDC/FS special needs families (i.e., caseheads who were non-legally responsible relatives, NLRR, and SSI caseheads); 4) aged and disabled adults with no dependents, and 5) nondisabled adults under 55 years with no dependents.

AFDC/Food Stamp Cases

Only 13 percent of the 25,387 cases on both AFDC and food stamps in December 1995 received a W-2 payment by September 1999, while 42 percent remained on food stamps and 53 percent remained on medical assistance. Of 22,028 cases which had left AFDC/W-2/food stamps by September 1999, 70 percent showed some reported earnings some time during the subsequent periods examined and about half (46 percent) were off AFDC by December 1996. Twenty-eight percent of this group received a W-2 payment at some time.

Most of the attrition for families on AFDC/food stamps took place during Pay for Performance. (During 1996 there was a 42 percent decline in the December 1995 AFDC population. Sixty- one percent of December 1995 AFDC/food stamp cases remained off AFDC as of October 1997 and 87 percent had no W-2 payment in August 1999.) The rapid decline in AFDC cases in 1996 was paralleled by a 30 percent decline in food stamp cases and a 20 percent decline in medical assistance cases. During the first 10 months of 1997 an additional 15 percent of food stamps cases and 14 percent of medical assistance cases closed. After W-2 began, the decline in the number of December 1995 AFDC cases receiving food stamps slowed. By September 1999, 58 percent of the December 1995 AFDC/food stamps cases were off food stamps and 47 percent were off medical assistance.

Families Receiving Food Stamps and Not AFDC

Cases with dependent children who received food stamps but not AFDC in December 1995 showed even higher attrition rates. This population was much more likely to be employed, with 78 percent showing earnings in December 1995. Half of the cases (51 percent) were no longer on food stamps one year later and three-fourths (76 percent) were no longer on food stamps by September 1999. A fourth of these cases (27 percent) were on or returned to AFDC some time after December 1995, but only 3 percent received W-2 payments in August 1999.

Families with Special Needs

Families with special needs (i.e., NLRR cases and cases with SSI caseheads) showed lower declines in public assistance. Twenty percent of the special needs cases on aid in December 1995 were off food stamps and 15 percent were off medical assistance one year later. By September 1999 the special needs population showed 44 percent off food stamps and 38 percent off medical assistance.


Food Stamp Retention Rates for Cases on Food Stamps in December 1995
Percent Off Food Stamps by:
Other Aid Status 12/95
N = 
12/96
10/97
2/98
12/98
9/99
On AFDC
25,387
30%
45%
48%
55%
58%
No AFDC, on MA
3,473
51%
66%
64%
74%
76%
Special Needs/AFDC
5,956
20%
31%
32%
41%
44%


Medical Assistance Retention Rates for Cases on Food Stamps and MA in December 1995
Percent Off Medical Assistance by:
Other Aid Status 12/95
N = 
12/96
10/97
2/98
12/98
9/99
On AFDC
25,387
20%
34%
37%
43%
47%
No AFDC, on MA
3,105
33%
53%
56%
62%
64%
Special Needs/AFDC
5,845
15%
23%
25%
33%
38%


AFDC Retention Rates for Cases on Food Stamps and AFDC in December 1995
Percent Off AFDC/W-2 Payment by:
N=
12/96
10/97
2/98
8/98
9/99
On AFDC 12/95
25,387
42%
61%
70%
79%
87%

December 1995 Food Stamp Cases with No Dependent Children

The food stamp population of adults with no eligible children was examined for December 1995 and tracked over time to assess changes in the caseload for two distinct groups:

  1. The aged (55 years and above in December 1995) and those on SSI made up 7,675 food stamp cases, or 60 percent of the adult only population. Half of this population received $10 per month as SSI cases. Most (69 percent) were women, and 98 percent had some other source of unearned income while only 2 percent showed an earned income source.

  2. The population aged 54 and under and not on SSI consisted of 5,114 adult-only cases on food stamps in December 1995. This population was mostly male (60 percent), and most cases (70 percent) received the standard $119 food stamp amount. This population in large part consisted of what would have been the general assistance group in the past. Some 47 percent showed a source of unearned income but only 6 percent showed a source of earned income.

    Subsequent public assistance status was tracked for both groups. The aged/SSI population remained on food stamps over time at a much higher rate than the under 55/non-SSI group. By September 1999, 43 percent of the aged/SSI population was still on food stamps while only 21 percent of the under 55/non-SSI group remained on food stamps.


    Retention Rates for Food Stamp Cases with No Dependent Children
    Non-SSI and Under Age 55 SSI or Age 55 and Above
    Number of cases in 12/95
    5,114
    7,675
        Still on Food Stamps 12/96
    41%
    73%
        Still on Food Stamps 10/97
    31%
    56%
        Still on Food Stamps 12/98
    21%
    47%
        Still on Food Stamps 9/99
    21%
    43%

    By September 1999, 4,053 cases (or 79 percent) under age 55 and not on SSI were no longer on food stamps and 96 percent were not on medical assistance. Of these cases only 23 percent reported earnings at any time during the periods examined.

    VI.    Analysis of Individuals Receiving Public Assistance in Milwaukee County

    Welfare records were examined for 195,632 Milwaukee County children and adults in the public assistance system for the month of December 1995, prior to the state's Pay for Performance initiative, and also for 176,511 children and adults in the welfare system in September 1999 after implementation of W-2. Individual records were matched with the food stamp, medical assistance, AFDC and W-2 status of individuals and the household in which they resided. For the 13,000-15,000 individuals in more than one case for food stamps or medical assistance purposes each year, welfare status was consolidated into one unique record per person. Each period was then examined for children and adults separately.

    Subsequent Status of Children in the December 1995 Public Assistance Files

    In December 1995, a total of 104,821 Milwaukee County children were in the welfare system files, including 90,895 children receiving food stamps or medical assistance. Most of these children (78 percent) were also in AFDC cases and receiving MA and food stamp benefits as well. Of the remaining children, 7,784 were on food stamps and medical assistance (but not AFDC), 6,191 were on medical assistance only, and 881 were on food stamps only.

    Subsequent Status of Adults in the December 1995 Public Assistance Files

    Milwaukee County adults on food stamps or medical assistance in December 1995 totaled 63,275. The majority (54 percent) were in AFDC cases, while 23 percent were in food stamp only cases, 16 percent in MA only cases, and 6 percent on food stamps and MA (but not AFDC).

    Children in the September 1999 Public Assistance Files

    In September 1999, 93,384 Milwaukee County children were in the welfare system, of which 80,898 were on food stamps, medical assistance or both.

    Adults in the September 1999 Public Assistance Files

    The status of adults in the welfare system in September 1999 was analyzed by groups based on assistance status.

    Case Turnover and Fewer New Cases Reduce the Population on MA and Food Stamps

    Persons in welfare cases in December 1995, December 1996, December 1998 and December 1999 were examined to assess changes in AFDC/W-2, food stamps and Medical Assistance coverage over time. A total of 305,910 individuals were in cases during the four periods examined (including 274,036 who received food stamps or MA at some time). Although the net decline in persons on MA from December 1995 (128,200) to September 1999 (112,547) was 15,653, turnover in the population during the four periods examined resulted in considerably more people losing their Medical Assistance coverage. For the four periods examined, 91,082 persons were on MA in December 1995, December 1996 or December 1998 who then lost their MA coverage by September 1999. For food stamps, the net decline was 28 percent; however, during the four periods examined, 104,624 persons lost food stamp coverage by September 1999. Most of the losses occurred prior to W-2 when the loss of AFDC benefits often triggered the loss of food stamps and Medical Assistance as well. During this pre-W-2 period, the decreasing number of "new" cases and individuals also helped reduce the overall population with coverage. In addition, if all new cases entering and exiting the system were considered (including activities in months not analyzed here), the number of persons losing coverage would be even higher.

    An example of benefit turnovers can be seen by comparing the December 1995 and December 1996 MA and food stamp caseloads, when the 128,200 persons on MA in December 1995 declined to 96,476 in December 1996. The addition of 27,396 MA recipients (not on MA in December 1995) brought the MA total to 123,872 for December 1996. However, half of these "new" MA recipients were located in welfare cases active in December 1995 and only 13,414 appeared to be new persons in new cases. By December 1998 the MA population declined to 106,910 persons of which 64,129 had been on MA in December 1995, another 13,262 had been on MA in December 1996, 12,946 were from cases active but not on MA in December 1995 or December 1996, and the balance (16,573) appeared "new" during the two-year period. Nine months later in September 1999, 101,793 of 112,547 cases were found to be active prior to W-2, 7,797 were active in December 1998, and only 2,957 were new cases in the first nine months of 1999.

    Persons remaining on MA account for much of the current MA population; 48,164 persons were on MA in all four periods examined since December 1995 and 21,255 were on MA three of four periods, most from former AFDC cases. Persons reentering or being added to cases account for the next largest share with few new cases entering the MA system.

    Similarly, the food stamp population was examined for the periods December 1995, December 1996, December 1998 and September 1999. The overall decline in persons on food stamps was greater than the decline in persons on MA. The number of food stamp recipients declined from 133,099 persons in December 1995 to 95,690 in September 1999, a drop of 28 percent. Most of the decline took place during the period prior to W-2. The number of persons leaving food stamps by September 1999 who had been on food stamps some time during the prior three periods (December 1995, December 1996, December 1998) totaled 119,131, while the number leaving MA was 91,082.

    The Potential Food Stamp and Medical Assistance-Eligible Population

    Declines in the Medical Assistance and food stamp caseload are attributable in large part to the decline in families receiving AFDC. Prior research on the earnings of AFDC leavers in Milwaukee County suggest that many may remain financially eligible for food stamps and Medical Assistance given their quarterly earnings. In the past, individuals signing up for AFDC were almost always eligible for MA and food stamps as well. Because of the similar MA eligibility requirements, many prior AFDC cases which lost all assistance may be eligible for MA, Healthy Start or BadgerCare. It is likely that many of the 119,131 Milwaukee County food stamp recipients and the 91,090 MA recipients who were on assistance in December 1995, December 1996 and December 1998 but are no longer on assistance may also be eligible for food stamps or MA (or both) -- particularly for MA due to the changes in income limits with the introduction of BadgerCare. One half of the 32,051 persons on MA and AFDC in December 1995 but not on in December 1996 also lost their medical coverage, although many of the children may have been eligible for Healthy Start.

    Review of the current caseload on MA and food stamps has found many additional adults likely eligible for medical assistance under BadgerCare. As a result, much of BadgerCare activity has consisted of providing health care to individuals in families currently on public assistance where the child(ren) may be on MA but not the parent or other family member. Over 100,000 Milwaukee County individuals are estimated eligible for medical coverage but are not covered. These include at least three distinct groups:


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