North Carolina Coalition to End Homelessness

Casualties of Complexity: Why Eligible Homeless People Are Not Enrolled in Medicaid

The complexity and diversity of state Medicaid programs present significant access barriers for impoverished people lacking residential stability, especially for those without the capacity to document their eligibility in prescribed ways. As a result, many eligible homeless people remain uninsured. Lack of health coverage seriously limits their access to needed health care, and threatens both individual and community health. This document identifies obstacles that prevent eligible homeless people from enrolling in Medicaid, describes how experienced homeless service providers address these problems, and recommends ways in which the obstacles can be surmounted or removed. Informal observations by Health Care for the Homeless providers that more of their homeless clients are ostensibly eligible for Medicaid than actually enroll stimulated the investigation that resulted in this report. The National Health Care for the Homeless Council sought to find out how serious and pervasive the observed gap between eligibility and enrollment might be, why it occurs, and what can be done to assure that eligible homeless people obtain the comprehensive health coverage they need. We were supported in this endeavor by the Health Care for the Homeless Branch, Division of Programs for Special Populations of the Bureau of Primary Health Care.
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Patricia Post
Author: Patricia Post
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