A progressive shift is underway in the state level of Medicaid, the U.S. health-coverage program, as an increasing number of states redefine its role to address social needs. The program is no longer confined to traditional healthcare; it is now a catalyst for supporting housing, transportation, post-prison reintegration, and assistance for survivors of domestic violence.
This transformation aligns with the Biden administration’s push to weave social determinants into healthcare strategies, a move met with bipartisan enthusiasm. The Centers for Medicare and Medicaid Services (CMS) has greenlit innovative projects in eight states, with the expectation that it will expand to other territories in the short or medium term.
States That Include House and Food Resources to Medicaid Users
Under the federal government’s guidance, the CMS are essaying this beta-testing program, so far, in eight states: Arizona, Arkansas, California, Massachusetts, New Jersey, New York, Oregon, and Washington. These projects, expanding Medicaid’s scope to cover social needs, require federal approval due to the collaborative nature of Medicaid between the federal government and states.
In a remarkable display of bipartisan support, even during the past Trump administration, in its final days in January 2021, suggested ways for states to leverage Medicaid and other public insurance to address social needs. This inclusive approach underscores a commitment to mitigating health inequities, resonating with the broader U.S. Playbook to Address Social Determinants of Health initiated during the Biden administration.
Moreover, nine additional states have submitted applications, while California, Massachusetts, and North Carolina are seeking updates for ongoing initiatives. This is an innovative approach on what Medicaid beneficiaries need could be the future of what the social services mean in the United States.
Other Social Programs to Do What Medicaid Is Doing for Americans
The guidelines provided by CMS in November opened avenues for states to incorporate various services under Medicaid, including up to six months’ rent, utility subsidies, and access to nutritious food. However, states engaging in these experiments must limit their spending to 3 percent of the overall Medicaid budget, contributing state funds while rigorously evaluating the outcomes. Simultaneously, the federal Medicare system has directed doctors to inquire about food insecurity, unstable housing, and personal safety when seeking bonuses in an incentive pay program.
This emphasis on social needs is not confined to Medicaid; even the organization accrediting U.S. hospitals mandated, a year ago, that hospitals inquire about unmet health-related social needs among their patients and provide guidance on obtaining assistance. The recognition that social determinants significantly impact well-being has been growing for at least three decades. Studies indicate that medical care only contributes to 20 percent of differences in patients’ health, while social risk factors play a more substantial role, ranging from 50 to 80 percent.