Many people have heard the stark statistics about U.S. well being care from a world perspective: when in comparison with different high-income nations, the U.S. spends a considerably increased proportion of our Gross Home Product (GDP, which measures the whole output of a rustic’s items and providers throughout a given time) on well being care, but we have now the bottom life expectancy at beginning, the very best demise charges for avoidable or treatable situations, the very best maternal and toddler mortality, and among the many highest suicide charges. This discordance—spending extra for worse outcomes—has persevered for many years.
There are myriad forces and components that drive and perpetuate this troubling actuality; amongst them is the outsized impression of poverty, and the way it prevents individuals, notably these in traditionally underrepresented and marginalized communities, from accessing crucial providers that would dramatically enhance and save lives.
Having a secure, secure house and constant entry to nutritious meals is key to an individual’s well-being and talent to take care of good well being. But many people throughout the nation and in Colorado lack these primary requirements, and the entities they depend on to assist – together with Medicaid well being plans and community-based organizations – typically lack sustainable funding to supply these providers. The State of Colorado has a chance now to incorporate meals and housing in well being care, main to raised well being outcomes, decreased well being care prices, and the prevention of homelessness.
Bipartisan laws this session (Home Invoice 24-1322) would allow the Division of Well being Care Coverage and Financing to review the right way to present sure housing and vitamin providers inside Medicaid and to pursue federal approval to take action by means of a Part 1115 waiver. These waivers permit states to check new approaches in Medicaid, and several other states – Arizona, North Carolina, Oregon, and extra – have already taken benefit of this transformative alternative to obtain federal approval for masking housing and vitamin providers corresponding to rental help and meal supply for populations with the best want. Historically, we don’t take into consideration meals and housing as part of well being care, however mounting proof reveals they’re key components in our total well being.
Because the state’s largest Medicaid well being plan, Colorado Entry serves roughly half one million members throughout Well being First Colorado (Colorado’s Medicaid program) and Little one Well being Plan Plus (CHP+). Addressing social determinants of well being corresponding to housing and vitamin provides a second of nice change and alternative for Medicaid.
From the Colorado Well being Entry Survey, we all know that: in Denver County, 35% of Medicaid members reported that they or their dependents ate lower than they thought they need to previously 12 months as a result of they may not afford meals. In Douglas, Adams, and Arapahoe counties, 36% of Medicaid members nervous that they might not have secure housing within the subsequent two months and/or reported issues paying their hire or mortgage previously 12 months.
A sturdy physique of analysis, together with evaluation of applications in Colorado, reveals the advantages of addressing social wants, together with much less time in emergency rooms, decrease well being care prices, and a discount of legal justice involvement. Our expertise serving Medicaid members right here in Colorado for almost 30 years affirms this.
Not solely does Medicaid assist for housing and meals for goal populations, corresponding to members experiencing homelessness and people who’re pregnant or postpartum, scale back future prices and save taxpayer {dollars}, however it additionally brings in additional federal {dollars} to our state – {dollars} that different states are already accessing.
Notably, Medicaid might doubtlessly pay for six months of rental help or short-term housing at a time when the variety of people experiencing homelessness in Colorado continues to develop. Medicaid might additionally cowl a spread of different providers, corresponding to pre-tenancy and tenancy assist providers, house modifications, and provides to take care of wholesome temperatures and clear air in excessive local weather occasions.
Along with housing assist, Medicaid might pay to handle meals insecurity by means of vitamin counseling and training, meal supply, medically tailor-made meals prescriptions, and hyperlinks to community-based meals assets.
We have to embrace the chance that this laws provides for Medicaid, and we recognize legislators’, advocates, and the administration’s assist. By addressing the social determinants of well being corresponding to housing and vitamin, we have now a brand new, significant alternative to enhance total well being and well-being of our communities and to redefine well being care to assist the entire individual.
Annie Lee is president and CEO of Colorado Entry. Earlier than becoming a member of Colorado Entry in 2022, she held management positions at Kids’s Hospital Colorado and Kaiser Permanente Colorado. Previous to that, Annie labored on the Colorado Division of Well being Care Coverage and Financing in each CHP+ and Medicaid advantages coverage.