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Housing As Health Care: The Debate Continues

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Housing Policy + Finance

Housing As Health Care: The Debate Continues

As more states channel Medicaid money into housing, the debate around whether states should use public health insurance money to provide housing is intensifying

February 9, 2024
Seated homeless man with 'Please Help' cardboard sign
Image: 2B / stock.adoeb.com

Last year homelessness nationwide jumped by about 12%, reaching the highest level on record. Clearly, solutions are needed.

One trend catching on around the country and an approach being encouraged by the Biden administration is for states to use public health insurance money to provide housing for the most needy and sick, the Lake County Record-Bee reports. At least 19 states are currently directing money from Medicaid into housing aid, with California pumping the most ($12 billion) into its Medicaid initiative to help homeless patients find, pay for, and stay in stable housing. And it’s not just states experimenting with this approach. The Kaiser Permanente health system has committed hundreds of millions of dollars of its own funds to help maintain or build thousands of affordable housing units, plus providing housing-related Medicaid benefits for members.

But whether this will provide a long-term fix for vulnerable patients’ health or housing needs is still being debated, and evidence supporting the approach is mixed. 

Peter Lee, another former Obama administration official and the founding executive director of California’s Obamacare exchange, said health care providers should consider offering some housing and social services, but he fears such initiatives may divert money from traditional medicine and prevent patients from getting adequate care.

“In the past five to 10 years, there has been a lot of recognition that health is about much more than actual health care. Very true,” Lee said. “The question is how do you address those issues while health care itself is not doing too great. The brass tacks of this is making sure people with diabetes have great diabetes care, that people get checkups in time, that people can get the regular health care they need.”

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