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Survey data from 901 community health center patients, who were potential and actual participants in these programs, indicated that while images of the Medicaid program and its recipients were generally positive, stigma associated with welfare stereotypes reduced both TANF and Medicaid enrollment. Expectations of poor treatment when applying for Medicaid, enrollment barriers, and misinformation about program rules were also associated with reduced Medicaid enrollment. States that enacted strict welfare reform policies were potentially decreasing TANF participation, while states with more simplified and generous programs were potentially increasing Medicaid participation. The results suggest that the image of the adult Medicaid program remains tied to perceptions about welfare and provides guidance to policymakers about how to improve participation rates. \u00a9 2004 by the Association for Public Policy Analysis and Management.<\/jats:p>","DOI":"10.1002\/pam.20024","type":"journal-article","created":{"date-parts":[[2004,6,9]],"date-time":"2004-06-09T16:18:56Z","timestamp":1086797936000},"page":"509-530","source":"Crossref","is-referenced-by-count":122,"title":["Stigma and other determinants of participation in TANF and Medicaid"],"prefix":"10.1002","volume":"23","author":[{"given":"Jennifer","family":"Stuber","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Kronebusch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,6,9]]},"reference":[{"key":"e_1_2_1_2_1","volume-title":"Voices for children's health in New York State: Community roundtables on increasing Medicaid and Child Health Plus enrollment","author":"Andrulis D.","year":"1999"},{"key":"e_1_2_1_3_1","volume-title":"The underclass: A first\u2010hand account of America's new social dropouts","author":"Auleta K.","year":"1982"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.2307\/2553477"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0047-2727(92)90025-B"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.2307\/145933"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.2307\/146043"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-6494.1974.tb00562.x"},{"key":"e_1_2_1_9_1","volume-title":"Uniform data system","author":"Bureau of Primary Health Care","year":"1999"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.90.6.900"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.14.1.255"},{"key":"e_1_2_1_12_1","volume-title":"Making it simple: Medicaid for children and CHIP income eligibility guidelines and enrollment procedures","author":"Cohen Ross D.","year":"2000"},{"key":"e_1_2_1_13_1","first-page":"95","volume-title":"Beliefs about recipient deservingness and program effectiveness as explanations of support","author":"Cook F.","year":"1992"},{"key":"e_1_2_1_14_1","first-page":"203","volume-title":"Brookings\u2010Wharton papers on Urban Affairs","author":"Currie J.","year":"2000"},{"key":"e_1_2_1_15_1","volume-title":"Access to and participation in Medicaid and the Food Stamp Program: A recent review of the literature","author":"Dion R.","year":"2000"},{"key":"e_1_2_1_16_1","volume-title":"American federalism: A view from the states","author":"Elazar D.","year":"1984"},{"key":"e_1_2_1_17_1","volume-title":"Statehouse democracy: public opinion and policy in the American states","author":"Erikson R.","year":"1993"},{"key":"e_1_2_1_18_1","unstructured":"Fix M. &Zimmerman W.(1998).Refusing a helping hand. 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