Currently, states can reap bonuses for showing that welfare recipients are working and for reducing out-of-wedlock births.
"Reducing out-of-wedlock births is a significant way to reduce the risk of welfare dependency," said Olivia A. Golden, an assistant secretary at the department.
As a result of this vagueness, he said, the administration was proposing elimination of the reward for reducing out-of-wedlock births and using the money instead to finance new programs designed to support healthy two-parent marriages.
"Over the long run," Mr. Johnson said, "we felt seniors would be better served by reducing out-of-pocket costs in the doughnut hole, as opposed to a rebate in the so-called dual eligibles".
The policy in the United States, as set forth in the welfare reform law, specifically includes reducing out-of-wedlock pregnancy, promoting marriage and encouraging the maintenance of two-parent families.
In the annual Unesco Education for All global monitoring report, published on Wednesday, Rwanda is listed as one of three top performing countries in the world (with Laos and Vietnam) for reducing out-of-school populations by at least 85% over the past five years.
"Combined with Unesco's recent news that aid to education has fallen yet again, the lack of progress in reducing out-of-school numbers confirms our fears – there is no chance, whatsoever, that countries will reach the goal of universal primary education by 2015," she said.
The federal government's prescription drug plan for the elderly, known as Medicare Part D, has been heralded as a success when it comes to reducing out-of-pocket expenses for many patients and encouraging them to use and continue taking essential medicines.
Health In Reach – Reducing out-of-pocket dental and medical costs.
Training for providers on rational prescribing behavior and use of generic medicines could be an effective and low cost approach to reducing out-of-pocket expenditures while maintaining quality of care.
