Dr. Laurie A. Grow:

The Impact of the 1996 Welfare, Medicaid and Immigration Reform Legislation on Access to Health Care for Low-Income Latina Women

University of Kansas, Medical Sociology

Dissertation Abstract

The purpose of this dissertation is to obtain a broad picture of how the 1996 welfare-Medicaid and immigration reform legislation has changed access to social services in the Latino American community. The controversial reform legislation has redefined the social and economic context in which low-income Latino immigrants seek and receive access to health care and public social services. While the intent of the reform legislation was to address specific social and economic problems at the macro-level of the social structure, the provisions of the legislation have had unintended, negative effects at the micro-level of the daily lives of the people affected by the policy changes.

I utilize the social constructionist perspective in sociology for analysis of data obtained from qualitative interviews with thirty-eight low-income Latina women, and with five representatives of three social outreach agencies serving the low-income Latino population in the greater Kansas City at area hospitals serving low-income Latino patients.

I seek to understand the shifting meaning and significance of immigration and citizenship status in regard to the rights of immigrants to receive social services. I contend that passage of the 1996 welfare reform and immigration reform legislation has altered the social, political, and economic context in which immigrants seek access to public health insurance benefits. Furthermore, the rapid recent increase in the Latino population, coupled with rising concern over the costs of the public benefit programs, has increased levels of racial-ethnic competition, prejudice, and discrimination against Latinos that impede access to public insurance benefits and health care services.

I also address the adequacy of current resource utilization models in medical sociology to adequately represent the changed dynamics of access to and use of health resources in a rapidly changing post-modern society. Finally, I examine the issues of welfare, immigration, and concepts of universal citizenship and social rights in a post-modern world characterized by global economic networks and transnational migration.