The end of the millennium marked a major change in U.S. treatment of its low-income parents and children. In 1996, the U.S. implemented a massive welfare reform program called Temporary Assistance for Needy Families (TANF). This program replaced Aid to Families with Dependent Children (AFDC), eliminated the welfare safety net, and mandated that progressively larger and larger proportions of the population of low-income parents receiving public assistance work at least 30 hours per week. We have monitored the effects of these changes by conducting repeated in-depth interviews with 150 women from across Wisconsin who have been affected by these changes. The State of Wisconsin was a leader in implementing welfare reform. In the 1990's, Wisconsin implemented a massive welfare reform program called Wisconsin Works (W-2), a program that became the model for what later became the federal TANF program. Wisconsin had a long history of nationally significant innovation in social policy, beginning with such Progressive Era reforms as workers' compensation and unemployment compensation. 2 Wisconsin's 1990's governor, Tommy Thompson, established himself as a leading figure in the national welfare reform debate and became the U.S. Secretary of Health and Human Services in 2001. [End Page 759] Wisconsin applied the new welfare reform policies earlier, more radically, and more aggressively than any other state—the 30 hour work rule was applied to all low income parents receiving assistance who were not officially designated as disabled and whose children were older than 12 weeks. The speed and magnitude of this change were incredible, instantaneously forcing tens of thousands of people into the low-wage labor market, something thought to be nearly incomprehensible by major policy advisors only a few years before. 3 This change provided a new population of low wage workers to businesses and non-profit organizations and and no doubt contributed to the fact that Wisconsin's per capita income fell below the national average during this time period. 4 The emphasis of welfare programs instantly changed from providing services to those who required help to mandating that parents must work first before their families could become eligible for aid. Some argue that work was valued with little regard to whether or not the children left behind received adequate care or to what is needed to parent successfully. Because the changes which occurred quickly in Wisconsin are occurring more gradually in other states, Wisconsin can be considered a laboratory for the entire TANF program. 5 The experiences of the families in Wisconsin affected by W-2 and TANF are documented by our longitudinal qualitative research and provide insights into what families affected by TANF are experiencing nationally. These experiences vary according to the personal and family resources available to each woman. For the vast majority, welfare reform brought with it continued poverty and economic instability. A significant minority also experienced severe deprivation that included hunger, homelessness, and deteriorating health. The experiences of women facing welfare reform in the U.S. are in many ways parallel to the experiences of women in countries affected by the structural adjustment policies of the International Monetary Fund and World Bank. Parallels are most striking in the consequences of both sets of policies for the lives of women and children in the areas of nutrition, health, education, and child welfare. Both structural adjustment and U.S. welfare reform have resulted in reductions in health care and nutrition. Structural adjustment policies require that governments reduce spending, and this requirement has resulted in profound cuts in health care and food subsidies. 6 Since most of those dependent upon these programs were women and children, they were hurt the most by these cuts. 7 8 The increase in hunger and homelessness, 9 the increase in poverty; 10 11 and the decrease in health care expenditures resulted in an increase in the infant mortality rate. 12 [End Page...