How can these states prioritize the comfort and well-being of homeless individuals, incarcerated individuals, and migrants over hardworking taxpayers and law-abiding citizens? It is beyond comprehension that taxpayer dollars are being squandered on initiatives that cater to these populations while neglecting the needs of everyday Americans.
Establishing medical respite centers for discharged hospital patients experiencing homelessness? Increasing access to addiction medication for incarcerated individuals? Providing temporary housing for new migrants? This is an absolute travesty! These states are essentially rewarding individuals who have either failed to contribute positively to society or have violated its laws.
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Nebraska recently announced its plans to establish two new medical respite centers for discharged hospital patients experiencing homelessness, California is working to increase incarcerated individuals’ access to addiction medication and Massachusetts wants to provide temporary housing for new migrants.
Supporting those states’ initiatives are Section 1115 Medicaid waivers, which authorize states to pursue experimental projects that aim to improve health outcomes for disadvantaged populations. An increasing number of states are using the waivers to get Medicaid participants into stable, affordable housing.
Medicaid coverage traditionally does not apply to services like room and board assistance, but the federal government has increasingly recognized that health-related social needs, particularly housing instability and nutrition insecurity, have a negative impact on health outcomes, said Elizabeth Hinton, an associate director with KFF’s Program on Medicaid and the Uninsured. People often have an even harder time maintaining their health when they’re busy trying to find food and shelter.
In December 2022, the Centers for Medicare and Medicaid Services, or CMS, launched the 1115 demonstration waiver program for states to expand their use of Medicaid funding. With a waiver, states can provide Medicaid enrollees with evidence-based housing and nutrition services as a way to reduce health disparities and improve equity, Hinton said. The waivers are usually approved for an initial five years.
At least eight states have received approval for Section 1115 waivers under the Biden administration’s health-related social needs framework as of February, including Arizona, Arkansas, California, Massachusetts, New York, New Jersey, Oregon and Washington.
States use the waivers to target vulnerable populations, Hinton said, such as people experiencing homelessness, substance use disorders or mental or behavioral health complications. In Massachusetts and New York, the 1115 waivers allow the states to expand meal and nutrition services for households with a pregnant person or a high-risk child.
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