It is no secret that Salt Lake City has a homelessness crisis with an estimated 1,880 people — 625 of which are families with children — who spend nights in shelters or on the streets. Homeless persons have unique stories of what led them to the Rio Grande area, but they also share some commonalities. For example, 617 report having a mental illness, 465 report having substance use disorders, and 676 are either domestic violence survivors or military veterans.
With this knowledge, it is foolish to ignore the connection between health care and homelessness. It takes a tremendous amount of resources and a dedicated support system to manage jeopardized health. Unfortunately, because of the current coverage gap, too many Utahns who need this support are limited in their access to our health care system. Medicaid expansion can provide the much-needed funding and affordable health care to address the needs of our homeless friends and the tens of thousands of other low-income Utahns left uninsured.
Here are five ways Medicaid expansion could help the most vulnerable Utahns with a better quality of life and hope for the future:
- Primary care providers and other medical support providers can build relationships with their patients and provide necessary intervention when concerns arise. For example, routine women’s exams allow trusted, trained gynecologists to spot signs of abuse and connect individuals with a support network.
- Much of America’s homeless population suffers from cognitive impairment, likely due to brain injuries, neurological disorders or psychiatric complications. Specialists and testing, which are cost-prohibitive for anyone uninsured, would be available and allow for conclusive diagnoses, which are imperative in order to make connections with appropriate support networks.
- In addition to health care coverage, Medicaid expansion gives states more funding based off the neediness of residents. One option that would be beneficial to homeless persons is to increase community support services such as life skills training, coordination of health care providers or move-in support. Many of these agencies are currently on a wait list due to limited state funding, but Medicaid expansion dollars could make it easier to access these services.
- The opioid epidemic rages across our communities, including our homeless population. States like Ohio have found success by using Medicaid to provide coverage to the folks suffering from addiction. Though there is a current shortage of treatment beds for homeless Utahns, Medicaid dollars could allow qualification at more facilities, decreasing wait-times significantly. Studies reflect that the continuity of care that follows Medicaid patients, as opposed to those who solely receive treatment through jail programs, have higher success in full rehabilitation. Treating addictions without requiring someone to be incarcerated can make a smoother transition to independent living.
- Health Homes, an option with Medicaid expansion, allow those with mental illness to have coverage for two years in a supportive environment that links community support and integrates wellness and life skills, leaving the patient with better chances of independence upon departure.
Another benefit comes to the Utah taxpayer. Medicaid expansion ensures an enhanced federal match rate where the federal government pays 90 percent of the cost with Utah only needing to pay 10 percent. Utah’s current match rate is 70/30, where the federal government pays 70 percent and Utah pays 30 percent.
In addition to not getting the best match for our funds, we continue to pour money into the criminal justice system and ask them to shoulder the weight of an issue the public health community is much better equipped to handle when fully funded. Public safety is important, but a strategy based on public health principles will yield better outcomes for all concerned because it works at the underlying causes of the crisis. Medicaid expansion is fundamental to the success of #OperationRioGrande, and our leaders who came together to work on this issue should advocate for nothing less.
Stephanie Burdick is a public health student and an advocate for equity in health outcomes.