Stephanie Anthony, Patricia Boozang, and Mandy Ferguson, Manatt Health
Supportive housing combines transitional or permanent housing with support services that help people experiencing or at risk of homelessness, people with disabilities, and older adults to secure and maintain housing. Research shows that access to affordable, safe, and stable housing can improve health outcomes and reduce health care costs. While Medicaid typically does not pay for housing (room and board), it does pay for some clinical and non-clinical services that can help people obtain and maintain their housing. More recently, new federal authorities to cover housing-related services have motivated states to think more broadly about the Medicaid populations who could benefit from access to housing-related services and the types of services that can promote housing stability.
This issue brief provides an overview of the federal authorities under which states are able to cover nonclinical housing-related services for high-need Medicaid enrollees and also details how states are using these authorities to invest in supportive housing for diverse high-need Medicaid populations. As a companion to the issue brief, Manatt Health has produced State Investments in Supportive Housing: An Inventory of State Efforts, which provides an in-depth look at states that are leveraging federal authorities to offer supportive housing benefits.
On December 6, the Centers for Medicare & Medicaid Services published and made effective an interim final rule (IFR) with comment period regarding states’ ongoing unwinding efforts to redetermine eligibility for all Medicaid enrollees nationwide. This expert perspective summarizes the IFR, which interprets and implements the state reporting requirements and CMS enforcement authorities that Congress enacted last winter in the Consolidated Appropriations Act of 2023.
The 11th annual open enrollment period (OEP) is underway, providing consumers with an opportunity to enroll in health coverage for plan year 2024 through the Affordable Care Act Marketplaces. To support consumers during this OEP, State-Based Marketplaces (SBMs) are innovating to make health coverage more affordable and easier for consumers to enroll. This expert perspective highlights new initiatives being implemented by SBMs during the plan year 2024 OEP, including establishing or improving state subsidy programs to reduce out-of-pocket costs, expanding coverage for undocumented populations, or implementing policies to improve the enrollment process.
As the unwinding of the Medicaid continuous coverage requirement continues, both states and the federal government are tracking and monitoring the impacts of the resumption of eligibility redeterminations and disenrollments. Given the time-lags and caveats of CMS data, many states are publishing their own state data dashboards. To date, 46 states (including the District of Columbia) have released unwinding data in either an interactive dashboard or static pdf format, or are making public their required CMS Monthly Unwinding Data reports. This expert perspective includes an interactive map with links to state reporting, as well as a table tracking the unwinding indicators and disaggregated data that states are reporting on. SHVS will continue to update this EP as more states publish their unwinding data.