By Marcella Maguire, CSH Director Health Systems Integration
CSH and our partners have been closely monitoring health care debates across the country. As states, localities and the provider community explore exciting new strategies to expand supportive housing capacity, we are engaged at every level to determine what changes in health care policies may impact the programs and people we serve.
Focus on the States!
Although Congress is unlikely to agree on large scale reform anytime soon, actions at the state level are impacting Medicaid and health care policy overall.
The new administration is focused on giving states flexibility through Medicaid waivers. Approving and implementing such waivers are complicated processes between states and the federal government, and the law requires public engagement in developing them.[1]
States hoping to reduce spending have incorporated policies like cost sharing, work requirements, or Healthy Behavior Incentive programs that research shows could create barriers to health care access for vulnerable populations.
The foundational decisions regarding these waivers are made at the state level and we encourage supportive housing providers to engage with and educate your state officials on the impacts any changes could have or are having on the people you serve.
CSH will continue to review these waivers and other literature on health care policy and share what we learn with you.
Children’s Health Insurance Program Reauthorization
Congress will soon need to take up the reauthorization of the Children’s Health Insurance Program (CHIP). Like Medicaid, this is a state and federal partnership that historically has enjoyed bipartisan support.[2]  However, there is a strong possibility that some of the health care issues lingering from the spring and summer may be raised anew as this bill moves forward. House or Senate Leadership or other members of Congress could add sections to the reauthorization that directly impact Medicaid. As such, CHIP is worth following closely as the process unfolds.
Health Care & Housing Intersection a Busy One
As members of the Health Care Sector continue to embrace Population Health and Value Based Payment models, they are reaching into communities to affect the social determinants of health (SDOH). Housing is the most common SDOH raised in terms of greatest impact and the most complex factor to address.
The Urban Institute recently convened leaders in the field to discuss models that cities are using to improve health in their communities. And a recent paper from Mercy Housing highlights nine case studies where the health and housing sectors can come together to build healthier communities.[3]
The word is out to leaders in health care that they need to learn more about housing needs in their communities. This creates opportunities for the supportive housing community to broaden networks and educate and partner with the health care field. Throughout the fall, CSH will regularly highlight health and housing partnerships and, as always, we want to know what will assist you to better serve vulnerable people through supportive housing.
[1] http://www.legisworks.org/congress/79/publaw-404.pdf
[2] http://healthaffairs.org/blog/2017/06/26/whats-chip-got-to-do-with-it/
[3] http://www.liifund.org/wp-content/uploads/2017/07/LIIF_whitepaper_pages.pdf