Targeted Outreach, Assistance for Homeless Needed in Medicaid Expansion, Study Says

Nearly 75 percent of chronically homeless adults with incomes below the eligibility threshold for Medicaid expansion under the Patient Protection and Affordable Care Act aren't enrolled in Medicaid, according to a Health Affairs study.

Researchers analyzed data from a sample of 725 chronically homeless adults with income below the Medicaid expansion threshold, which is 138 percent of the federal poverty level under the PPACA. More than three-quarters of the sample had some kind of insurance, but only 25.5 percent were covered by Medicaid. There was a high prevalence of physical and mental health conditions among those studied. The sample's average score on the Short-Form Health Survey of physical and mental health was 39, more than one standard deviation below the national average of 50.

The Medicaid expansion could potentially lead to a substantial number of uninsured or underinsured chronically homeless adults getting coverage, according to the study. Furthermore, states could experience offsetting cost savings by reducing the number of homeless adults who are uninsured or who currently rely on state and local assistance other than Medicaid to pay for healthcare.

However, due to various factors such as distrust of public systems and literacy barriers, these adults face many challenges to Medicaid enrollment. Enrolling these individuals in Medicaid would require states to employ targeted outreach efforts to build trust and rapport in addition to one-on-one assistance during the enrollment process, according to the study.

More Articles on Medicaid Expansion:
Study: No Medicaid Expansion Means No New Options for Low-Income Uninsured 
14M Newly Insured Will Hit the Market Next Year: How to Start Preparing
Economist: States Not Expanding Medicaid Will Hurt Rural Residents 

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