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Health Care
May 18, 2017
Mental Health Patients Gain Treatment Access Under New Medicaid Rule
Helping people exit the Medicaid system would leave more resources for needier mental health patients, experts say.
Health Care
May 18, 2017
Virginia Lawmakers Reject Medicaid Expansion as Congress Stalls
An attempt to override the governor's veto failed.
Health Care
May 15, 2017
House Passes Repeal and Replacement of Obamacare
The bill would give states the option to reject Obamacare mandates partially to blame for increasing insurance prices.
More News
Health Care
May 15, 2017
Freedom Caucus Backs House-Approved Obamacare Replacement
Leaders of the House Freedom Caucus struck a compromise with centrist Republicans previously opposed to the American Health Care Act.
April 26, 2017
New Mississippi Law Tackles Welfare Fraud
Mississippi Gov. Phil Bryant (R) approved a bill requiring government agencies to verify whether recipients of food stamps and other entitlement programs, such as Medicaid, are eligible to receive those benefits.
Government Spending
April 25, 2017
Trump Signals Support for Welfare Reform
Congress sent President Donald Trump a resolution blocking a U.S. Department of Labor (DOL) regulation that prevents state governments from testing individuals for evidence of illegal drug use when applying for entitlements.

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