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How has the ACA Medicaid Expansion Affected Providers Serving the Homeless Population: Analysis of Coverage, Revenues, and Costs

March 2016

Matt Warfield, Barbara DiPietrio, Samantha Artiga


States that expanded Medicaid coverage experienced larger gains in insurance coverage for patients that use services provided at Health Care for Homeless (HCH) projects. In expansion states, HCH projects experienced higher revenues and lower costs. Non-expansion states only saw a 4% increase in coverage among those suffering from homelessness. HCH projects had higher costs and lower revenues as a result of less of their patients receiving coverage.

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Policy Implications

In non-expansion states, people suffering from homelessness are worse off in terms of insurance coverage, compared to those in expansion states. Along with that, the HCH projects that serve the homeless population in non-expansion states are faring worse compared to their expansion counterparts with less revenue and increased costs. They have more patients that are uninsured using their services, which in turn increases their costs and lowers revenue.

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