On Tuesdays in March, the Alliance has been blogging about the Affordable Care Act (ACA), which was enacted two years ago and is today (literally, today) the center of attention in the U.S. Supreme Court. As we and our partners have pointed out, the ACA is already helping very vulnerable people, including people experiencing homelessness – for instance, through a limited amount of new funding for community health centers. Other changes are coming on-line this year, such as Medicaid health homes, a state option that can help communities do a better job of coordinating health care and homeless assistance.
Still bigger changes are yet to come. If the key Medicaid expansion is upheld as constitutional, chronically homeless and at-risk adults who do not qualify now will have access to Medicaid benefits, starting in 2014. Even then, the promises of the ACA can fall short, if those benefits are not sufficient for people who need housing stability to recover and improve their health status. It is important for homeless advocates to have a voice in designing Medicaid benefits that make that link with concrete solutions when housing is necessary to complete an effective, person-centered care plan.
There is much work to be done. The ACA offers resources and innovative policies. Whatever the outcome in the Supreme Court, homeless advocates will continue to strive for community networks that seamlessly provide supportive housing, primary care and behavioral health services. We know this approach is necessary to end chronic homelessness.
In closing out this month of blogs on the ACA and ending homelessness, let’s give due notice to how the ACA could touch people experiencing homelessness who fit other typologies besides chronic. Two examples come to mind:
- At-risk young people – Research shows that children who age out of foster care frequently have significant health care needs, especially compared to other young adults. Under the ACA, states are now required to consider access to health care as part of the transition plan for young adults exiting foster care. Starting in 2014, states will have the further requirement of extending Medicaid coverage to these individuals until they reach age 26. Advocates for homeless youth have a role to play as states implement this new provision. For more information about access to health care for foster youth, a recent blog at Community Catalyst is a place to start.
- Vulnerable families – The ACA funds the Early Childhood Home Visiting Program, allowing states to target evidence-based programs for children under age 5. These services may be critical to outcomes for children who have experienced homelessness. Homeless service providers are well positioned to help home visiting succeed by informing strategies to target these new resources, and giving valuable feedback about how the program addresses needs of homeless families.
The Alliance will continue to analyze health care reform and its implications for ending homelessness. For more information about homelessness and health, visit our website or contact us at firstname.lastname@example.org.