Medicaid Work Requirements will Harm People Experiencing Homelessness

Many Experiencing Homelessness Will Lose Medicaid Coverage and Face Worsening Health Outcomes

A new report from the Center on Budget and Policy Priorities shows the dramatic extent to which Medicaid expansion improved healthcare coverage for people experiencing homelessness. The work requirements will undercut this progress.

The authors maintain that by making care harder to access, Medicaid work requirements will worsen outcomes and exacerbate homelessness.

“Medicaid expansion under the Affordable Care Act (ACA) significantly increased health coverage for people experiencing homelessness, a group whose mortality rates are three to four times higher than the general population.”

The Trump administration has made a decision to allow states to pull back Medicaid coverage from certain populations including those who qualify for Medicaid based on a disability.

“Before states could expand Medicaid eligibility under the ACA, most adults experiencing homelessness did not qualify for Medicaid unless they could prove they had a physical or mental condition that qualified them for coverage based on a disability. People experiencing homelessness are more likely to have a disability than the general population, but they have a harder time proving it, in part because lack of access to health care can mean they have limited medical evidence of their conditions. Now, adults in expansion states with incomes up to 138 percent of the poverty line can enroll regardless of disability, making coverage available for far more people experiencing homelessness and providing them with access to both routine and urgently needed health care. This is especially important because homelessness can cause health problems, worsen existing conditions, and make it harder for people to engage in care.”

It is not hard to imagine what will happen to the stability of the individuals experiencing homelessness who have been given access to healthcare but now face the threat of losing it. If this population loses coverage, their health outcomes will worsen.

“As noted, people experiencing homelessness have higher rates of many physical and behavioral health conditions than the general population, and homelessness can make it harder to treat those conditions. For people with such serious health needs, coverage interruptions can lead to increased use of emergency departments, admission to hospitals and mental health facilities, and higher health care costs, research shows.”

New Jersey is not one of the states to approve a work requirement.

CBPP Report on Medicaid and Homelessness

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