Living and Working in the Coverage Gap: Homeless Health Care in States Yet to Expand Medicaid

November 13, 2014 | 1-2 p.m. Eastern

State decisions whether to expand Medicaid eligibility under the ACA have huge ramifications for state health care systems, fiscal stability, and safety net programs. One of the most pressing issues is the coverage gap that remains in states yet to expand where residents earn too little to purchase private plans on state or federal Marketplace systems, but do not qualify for Medicaid under current state guidelines. This has maintained or exacerbated problems of limited access and uncompensated care throughout the health care system, particularly for HCH projects. The vast majority of currently uninsured HCH consumers in non-expansion states fall into this coverage gap, creating new challenges during enrollment activities and deepening old challenges regarding access to care.

While this circumstance is clearly difficult, the HCH community working in non-expansion states can learn a great deal about how others in similar situations have managed during the first year of ACA implementation. This webinar will explore these challenges and potential solutions to providing homeless health care in a non-expansion state, drawing on the experiences of HCH program directors, enrollment staff, and consumers. Featured guest speaker, Judy Solomon from the Center on Budget and Policy Priorities, will also discuss the implications of Medicaid expansions nationally, their impact on safety net providers, and possible ways forward in the coming years.  


  • Dan Rabbitt, MSW, Health Policy Organizer, National HCH Council
  • Judy Solomon, JD, Vice President for Health Policy, Center on Budget and Policy Priorities
  • Jenn Hyvonen, MPC, HCH Director, Fourth Street Clinic
  • Monique Winters, Certified Application Counselor, St. Joseph’s Mercy Care
  • Jeff Driver, Consumer Advisory Board, Downtown Clinic

Download the presentation slides