An increasing number of states are diverting some of their Medicaid funds toward housing assistance for the homeless. [Source]
Medicaid, a program traditionally aimed at providing medical assistance to low-income individuals, is being utilized to combat the broader social determinants of health.
The program, overseen by the federal government but customized by each state, has seen at least 20 states integrating housing support into their services.
While celebrated by some as an innovative solution to reduce health issues exacerbated by inadequate living conditions, this move has sparked debate over the appropriateness of allocating health care funds to non-medical services.
Dr. Marc Samuels, CEO of ADVI Health, explained the flexibility states have in tailoring Medicaid to address broad health and social issues. “States have broad flexibility in their Medicaid programs to create a program that is unique,” Samuels stated.
States such as Arizona, California, New York, Oregon, and Washington have secured federal approval to offer short-term housing assistance through Medicaid, leveraging a specific waiver known as the Section 1115 demonstration waiver.
These states and others like Arkansas, Massachusetts, and New Jersey are trying to link housing stability with improved health outcomes.
California leads with its ambitious plan, introduced by Governor Gavin Newsom, earmarking $12 billion over five years to expand Medi-Cal, the state’s Medicaid program, to encompass a variety of social services, including housing deposits, moving costs, and rent assistance.
However, the criticism of such initiatives is pronounced among skeptics who argue that these efforts could lead to a misallocation of funds that should be directed towards direct medical care.
Dr. Marc Siegel, a clinical professor of medicine, voices a common concern among critics, asserting that providing housing through Medicaid is a misguided solution that fails to address the root causes of homelessness, such as mental health issues and substance abuse.
“It is a huge money drain on the state and it doesn’t solve the underlying problems of chronic mental health issues, excess drug use and the spread of infectious disease — not to mention the unemployment that drives all of it,” he told Fox News Digital.
Siegel’s perspective underscores a fundamental critique: Medicaid’s foray into housing support could inadvertently prioritize the homeless at the expense of other vulnerable populations in need of medical care. This concern reflects a broader apprehension about the expansion of Medicaid beyond its traditional scope, potentially at the cost of its core mission to provide health care.
Shipman advocated for directing investments towards meeting the social needs of communities instead of continuously funneling additional funds into advanced medical care technologies, a practice he believes results in excessive spending and underwhelming outcomes.
Despite these criticisms, some health care professionals and policymakers advocate for a more inclusive understanding of health care that addresses the necessity of stable housing as a precondition for health.
Dr. Colin Banas and Scott Shipman, M.D., emphasize the intrinsic link between housing and health, arguing that secure housing can lead to better health outcomes and reduce the cycle of emergency care and hospital admissions among the homeless.