For Homeless People Accessing ACA Benefits, Advocacy is Key

written by Lisa Stand
March 27, 2014

True or false: March 31 is the last day to help people experiencing homelessness sign up for health coverage under the Affordable Care Act (ACA)? The answer is – probably FALSE. That’s because many vulnerable people experiencing homelessness may qualify for Medicaid. Enrollment in Medicaid is ongoing, and not affected by the annual “open season” that ends next week for some other ACA programs.

People with low incomes and people with no incomes can still use state exchanges to find out if they qualify for Medicaid, and begin enrolling if they do. In states that chose to expand Medicaid, adults with incomes up to 138 percent of the poverty level can receive basic benefits at least. In all states, people with more severe conditions may qualify for enhanced coverage defined in each state.

Homeless advocates have been at the forefront of enrollment efforts since the state exchanges opened last October. That is not surprising, since these advocates are always pursuing ways to improve the lives of people who experience homelessness. Access to health care and supportive services can make an enormous difference for people who are chronically homeless. Good coverage helps them manage their mental health, recover from trauma, and address co-occurring medical needs. Appropriate supportive services can help them remain stable after placement in permanent housing.

Many low-income people with disabilities are eligible for Supplemental Security Income (SSI). SSI pays limited cash benefits (around $800 monthly) that can cover a portion of rent, as required by most supportive housing programs. In many states, eligibility for SSI leads automatically to enrollment in Medicaid disability programs.

Despite its value, SSI is not always easy to access for people experiencing homelessness. They may lack important documents, or have cognitive impairments that keep them from completing applications. Sometimes it takes more than one attempt to qualify as disabled.

Fortunately, resources are available for those who help people overcome obstacles to Medicaid and SSI. For instance, the ACA currently supports staff at community health centers to help people enroll in health care coverage. For SSI, there is the SOAR program sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). SOAR stands for SSI/SSDI Outreach, Access and Recovery. It is a program that equips community workers with knowledge and skills to help people apply for programs like SSI when they are homeless or at-risk of becoming homeless. In SOAR-trained communities, applications for disability benefits are approved at a much higher rate than other places – 65 percent versus 29 percent.

Timely access to benefits – Medicaid, SSI or both – means better opportunities to succeed in permanent supportive housing. Frontline homeless assistance workers are an important link to these programs, and they also help bring needed resources to the community as a whole. For instance, SOAR analysts recently estimated that benefits for people SOAR served brought $188 million to local economies.

Click here for more information about how the ACA is helping end homelessness.