New Publication: “How Has the ACA Medicaid Expansion Affected Providers Serving the Homeless Population: Analysis of Coverage, Revenues, and Costs”

Policy Brief FigureThe National Health Care for the Homeless Council has collaborated with the Kaiser Family Foundation on a new policy brief,How Has the ACA Medicaid Expansion Affected Providers Serving the Homeless Population: Analysis of Coverage, Revenues, and Costs.” The Affordable Care Act (ACA) Medicaid expansion to adults closed a longstanding gap in eligibility in the 32 states, including DC, that have adopted it to date, providing a new coverage option for millions of uninsured adults. In Medicaid expansion states, many people experiencing homelessness are newly eligible for coverage since this population includes many single adults who were excluded from Medicaid prior to the expansion. Coverage is particularly important for this population given that they have poor health and intensive health care and social service needs.

To further understand how the first full year of Medicaid expansion has affected patients who are homeless and the providers who care for them, this analysis uses data from the Uniform Data System (UDS) for health centers to examine changes in insurance coverage, revenues, and costs among Health Care for the Homeless (HCH) projects serving the homeless population. Key findings include the following:

  • There have been significant coverage gains among patients at HCH projects since implementation of the ACA in 2014, with much larger gains among patients at HCH projects in states that expanded Medicaid compared to non-expansion states.
  • HCH Projects in expansion states also had larger gains in revenue and smaller increases in costs compared to those in non-expansion states
  • For HCH projects in expansion states, third-party payments increased as a share of total revenue due to coverage gains among patients.
  • The distribution of costs remained fairly stable among HCH projects in both expansion and non-expansion states.

Read the full brief.