Potential New Opportunities to Use Medicaid Dollars on Housing

In response to the growing understanding of the impact housing has on health outcomes, the Biden administration has taken important steps to leverage Medicaid dollars for housing supports.

Historically, Medicaid has not covered “room and board” housing services. However, the administration’s recent actions have created two major opportunities to improve this. First, there is recent willingness to approve Section 1115 demonstrations that authorize limited temporary housing services within Medicaid as a health-related social need (HRSN) as described in CMS guidance, with additional funding for capacity building and successful implementation. Second, the administration’s recent guidance permits states and Medicaid managed care plans to offer short-term housing supports using the “in lieu of” services approach. These changes open the door for states to propose housing services targeting various populations, including those at risk of homelessness.