Protecting Medicaid Beneficiaries

As the new Administration and Congress begin their work, and their focus turns to national healthcare policy, CSH wants our leaders to recognize the proven role supportive housing plays in reducing healthcare costs while improving outcomes for individuals with complex health conditions and housing instability - instability that, without a cost-effective intervention, leads to a need for far more expensive health care services.

Medicaid is a crucial part of the equation to ensure better health for those in supportive housing and we are actively engaging policymakers to protect beneficiaries under this coverage. CSH is circulating our position within every level of government and asking other organizations and individuals to sign on with us.

Every day doctors in America provide treatment to some of our sickest patients who live on the streets, in shelters, institutional settings or unsafe, tenuous housing. Despite heroic efforts by our nation's health care professionals, they often do not have the right tools and resources to treat many of the most pressing needs of these individuals.

These patients often lack access to basic needs like housing, transportation, preventative care, and social supports. Medicine and medical interventions alone will never resolve the complexity of issues they face. Most will return to the clinic or hospital emergency department again and again, with more serious and expensive problems.

There is a growing consensus among health care professionals and policymakers that in order to break this cycle of crisis system utilization, increase cost-efficiency, and improve health, our country must shift attention and dollars toward systematically addressing social determinants of health that create cost-effective, longer-term impacts on the health of a community. Based on mounting research, it is clear that underlying, contributing factors of health impact the needs and behavior of generations.

Access to safe, quality, affordable housing and the supports necessary to remain in that housing is the essence of supportive housing, and constitutes one of the most fundamental and powerful social determinants of health. Yet supportive housing, a proven model producing measurable results, remains woefully under capacity in our country.

As the Trump Administration and Congress consider reforms impacting healthcare, we want them to take actions that will expand the positive impact supportive housing has on individuals and families. Specifically, we are urging them to:

  1. Ensure that health coverage for the lowest income Medicaid beneficiaries continues even if the Affordable Care Act is altered or repealed.
  2. Encourage and increase access to housing resources to pair with the healthcare system, a proven model for reducing public costs while serving as a platform for improved health and economic sufficiency.
  3. Encourage more states to incorporate supportive housing pre-tenancy and tenancy sustaining services in their Medicaid Plans.
  4. Provide states with new resources and authority to increase Medicaid beneficiaries' use of Home and Community-Based Services (HCBS), responding to the individual's preferences to live at home or in home-like settings. By substituting for more expensive institutional services, increasing the use of HCBS has the potential to further reduce costs and expand access to long-term supports in states with waiting lists for services.

As we move forward, the most fitting question is not how will we afford to pay for social determinants of health such as supportive housing, but whether we can afford not to pay for a proven intervention that improves our quality of health and the efficiency of the healthcare system.