Improving Medicaid Access for People Experiencing Chronic Homelessness: State Examples

摘要

People who are chronically homeless face significant barriers to Medicaid enrollment. Some people are not eligible for Medicaid unless the state uses a waiver to expand eligibility. The eligibility determination process itself presents barriers, particularly for people with no address and for people with mental illness and addiction disorders. Also, people can quickly lose their Medicaid enrollment by incarceration, admission to an Institution for Mental Disease, or by not completing a required redetermination process. Several States have improved this populations access to Medicaid. Many initiatives highlighted in this report targeted a more broad population than people who are homeless. For example, states covered childless adults in 1115 waivers and simplified their eligibility procedures to reduce the number of uninsured people in general. Also, some Medicaid agencies coordinated with prisons or jails to cooperate with efforts to reduce criminal recidivism, not necessarily to reduce homelessness. States adopting similar initiatives to reduce chronic homelessness may find that the benefits and costs of their efforts reach well beyond the people who are chronically homeless.