Skip Navigation


Health Care
April 23, 2017
Study: Medicaid Block Grants Would Save $150 billion by 2022
Various Republican proposals would cap Medicaid spending.
Health Care
April 10, 2017
Analysis: Real Health Care Reforms Pass the ‘Calendar Test’
Robert Graboyes argues state and national health care reform efforts fall short of true reform when they fail to pass this litmus test.
Health Care
April 5, 2017
Health Care Negotiations Heat Up After GOP Leadership Setback
Congress and President Donald Trump continue to negotiate proposals to repeal and replace Obamacare.
More News
Health Care
April 5, 2017
Kansas Gov. Brownback Vetoes Medicaid Expansion
The Kansas House upheld Gov. Brownback's veto of Medicaid expansion 81-44 on April 3.
Health Care
April 5, 2017
Congressional Libertarians Back Obamacare Replacement Act
The bill represents ideological differences from the American Health Care Act and Affordable Care Act.
Health Care
March 14, 2017
Health Care Spending Increases, Federal Share Rises
The federal government spends more on health care than any other entity or group, in part due to Medicaid expansion under the Affordable Care Act.

The Issue

Most state governments can improve the effectiveness of their efforts to help those in poverty.

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ended the national entitlement to welfare and gave states considerable latitude in designing their own programs. Some governors and legislators took full advantage of the opportunity and produced spectacular results, reducing welfare rolls as well as poverty and unemployment. Other states have been less active and less effective. What did successful states do, and what did unsuccessful states fail to do?

Our Stance

Successful welfare reform can save lives and produce positive effects on multiple generations. It can save taxpayers billions of dollars and help address such serious social maladies as crime, alcoholism, and teenage pregnancy. And it can demonstrate that government programs can be successfully devolved from the national government to states.

Featured Subtopics

Busy medical waiting room
Medicaid is an expensive program that provides very poor quality care, yet health care providers and employers continue to push states to expand the program as authorized by the Affordable Care Act. The allure of federal dollars has proven difficult for most states to resist.
Woman shopping for groceries
Today, 14.6 percent of the U.S. population is receiving assistance under the Supplemental Nutrition Assistance (SNAP) program. It is now one of the fastest-growing welfare entitlements in our federal budget, and one of the largest.
Hungry child with empty bowl
In 1996, the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) block-granted the old Aid to Families with Dependent Children (AFDC) federal welfare program to the states, giving them the flexibility to reform their welfare systems. The state-run program is now called Temporary Assistance to Needy Families (TANF)

Additional Subtopics

  • Dependency
  • Medicare
  • International
  • Social Security
  • Unfunded Liabilities


Title: Emerging Issues Forum (EIF) Nashville: Certificate of Need, Direct Primary Care, and Medicaid
Description: The forth panel covers direct primary care, Medicaid reform, Obamacare and certificate of need laws. Speaking on this panel are Dr. Hal Scherz of Docs4PatietCare; Heartland State Government Relations Manager Logan Pike; and Vice President of Policy for the James Madison Institute Sal Nuzzo.

Entitlements Experts Team

The Heartland Institute's experts on entitlement policy are available for legislative testimony, speaking engagements, and media interviews.

Heartland Staff Policy Experts