The scope of homelessness and housing insecurity as an issue is substantial. According to the U.S. Department of Housing and Urban Development 2019 point-in-time estimates, approximately 568,000 people around the country are homeless on any one night. Around two-thirds stay in emergency shelters or transitional housing programs. The remaining third reside in unsheltered settings.
Policy makers and Medicaid administrators realize the value in achieving housing security for Medicaid beneficiaries as a means of improving health outcomes and decreasing high-cost healthcare services. Housing security is a social determinant of health, playing a major role in influencing a person’s health and well-being. To that end, the federal and state governments are pursuing ways to provide Medicaid beneficiaries with a variety of housing-related services.
In this brief, Milliman’s actuaries and consultants explore the flexibilities available under Medicaid to address homelessness and housing insecurity, including Section 1115 Demonstrations Waivers and the new Healthy Adult Opportunity.