Medicaid, the federal-state health insurance program for low-income Americans, provides access to primary care, mental health and substance use treatment, and long-term care services for some of the country's most vulnerable citizens, including people with disabilities, youth in foster care, and people who experience homelessness. As a result of national health care reform, states are making substantial changes to their Medicaid programs, many of which will help expand access to essential health care services including home and community-based services that can help people with disabilities be successful in the community. The Affordable Care Act (ACA) included numerous provisions that are having an impact on people with disabilities such as:
- Expanded access to the Medicaid program;
- Improved access to behavioral health and substance use services;
- More options for states to serve individuals in home and community-based settings as opposed to institutions;
- Workforce development and payment reform initiatives designed to improve access to primary and preventative care services; and
- Incentives for improved coordination between physical and behavioral health care.
Medicaid plays a critical role in financing services and supports for many individuals in need of permanent supportive housing. The U.S. Centers for Medicare and Medicaid Services (CMS) released an Informational Bulletin outlining the specific housing-related activities and services that can be reimbursed for Medicaid covered individuals with disabilities, which include transition to housing and housing retention services that may be provided to assist vulnerable people with disabilities who need additional supports to regain and/or maintain housing.
Meeting health and behavioral health needs allows many people to stabilize and move directly from homelessness into housing. Further, using Medicaid to address a costly health crisis can prevent a household from having financial troubles and being at risk of homelessness. Studies have documented that helping homeless people in the community is more cost-effective than providing services in expensive public settings - such as hospitals, jails, mental health facilities, and institutions. The federal government has prioritized linking homeless people to Medicaid, redirecting housing resources back to housing by increasing U.S. Department of Housing and Urban Development (HUD) resources to communities that demonstrate strong linkages.
TAC Resources on Medicaid:
Other Medicaid Resources:
Health Reform Resources:
Healthcare.gov Health Reform website of the U.S. Department of Health & Human Services (HHS)
HUD Resource Library Page for the Affordable Care Act (ACA) on the OneCPD Resource Exchange
Kaiser Family Foundation summary of the law, implementation timeline & how health reform affects Medicaid
National Council for Community Behavioral Health summaries, facts sheets, implementation timelines & webinars