Friday, September 20, 2013

Fwd: qotd: Health care coverage for the homeless

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-------- Original Message --------
Subject: qotd: Health care coverage for the homeless
Date: Fri, 20 Sep 2013 02:27:38 -0700
From: Don McCanne <>
To: Quote-of-the-Day <>

Health Affairs
September 2013
Medicaid Expansion: Chronically Homeless Adults Will Need Targeted
Enrollment And Access To A Broad Range Of Services
By Jack Tsai, Robert A. Rosenheck, Dennis P. Culhane and Samantha Artiga

Prior to health reform, eligibility for Medicaid was limited to
low-income people in certain categories, including children, pregnant
women, parents with dependent children, people who qualified as
disabled, and elderly adults. The Medicaid expansion in 2014 extends
eligibility to low-income, nonelderly, nondisabled adults without
dependent children—often called "childless adults"—who were historically
excluded from the program.

Among other people who could gain coverage under the Affordable Care
Act's Medicaid expansion are the estimated 1.2 million people across the
country who are homeless in a given year, including roughly 110,000
chronically homeless adults. Given their low incomes, many currently
uninsured or underinsured homeless adults will gain from the Medicaid
expansion a new pathway to coverage and new health care opportunities.


The Medicaid expansion under the Affordable Care Act will likely
increase coverage options and provide broader access to care for many
chronically homeless adults who are uninsured or rely solely on state or
local assistance programs. Moreover, states that expand Medicaid may
experience offsetting cost savings, as chronically homeless adults who
previously relied on state and local assistance transition to Medicaid.
Conversely, in states that do not expand Medicaid coverage, poor
uninsured adults will not gain a new coverage option, and many will
likely remain uninsured and continue to face barriers to accessing
needed care.

The findings of this study illustrate the broad and varied health care
needs of chronically homeless adults. Ensuring access to preventive and
mental health services is particularly important for addressing the
needs of this population, and the services available to this group
should include case management and other supportive services, such as
help with housing.

Comment: For those states that expand Medicaid, many of the chronically
homeless will have an opportunity to obtain health care coverage - much
needed in this vulnerable population. However, these individuals face
many hurdles in both initial enrollment and maintaining enrollment in
Medicaid. Many will still be without adequate coverage. This is
unfortunate since we could have eliminated the coverage problem by
establishing a single payer national health program - enroll once and it
is for life. We could still do that.

For more information on health care for the homeless, see the website of
National Health Care for the Homeless Council:

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