Affordable Care Act provision a boon to the homeless – and maybe states

As many as three-quarters of chronically homeless people will be eligible for additional medical benefits under provisions of the Affordable Care Act, according to a new study appearing in the September issue of the journal Health Affairs.

In addition, the states that accept an increase in Medicaid funding provided by the act will save money in caring for the homeless.

“Currently, medical care for the homeless is haphazard and a lot of state and local money is dedicated to their healthcare,” said Jack Tsai, assistant professor of psychiatry at Yale, and a core investigator for the Veterans Affairs New England Mental Illness, Research, Education, and Clinical Center and the study’s lead author. “The homeless will be eligible for more comprehensive services than they are now.”

However, there are strong objections to the Affordable Care Act in many states and some have refused additional government funding for Medicaid.  Currently, 28 states have sought or are actively seeking additional Medicaid funding, Tsai said.

The study analyzed data from 725 homeless in 11 cities and found that almost three-quarters of those who might be eligible for Medicaid were not enrolled in the program.  Fifty-three percent were uninsured or relied exclusively on state or local programs for assistance. Twenty-one percent had some other form of coverage.

The study said even in states which have requested expanded Medicaid funding aggressive outreach to the homeless will be needed to ensure they receive additional physical and mental health services and coordinated case management services required by the law.

The second Yale author on the paper is Robert A. Rosenheck, Dennis P. Culhane of the University of Pennsylvania and Samantha Artiga of the Kaiser Commission on Medicaid and the Uninsured are the other authors.

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