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Supportive Housing Could Be First to Go if Medicaid Cuts Pass

Even with a series of recent defections, Republicans are still working to roll back Obamacare. Various versions of their bill have all had a couple things in common—tens of millions would be made uninsured and Medicaid would be slashed dramatically.

Between trying to figure out how many people would die, how many people would lose insurance, and just how much money billionaires would save, there are a lot of pieces of this bill worth investigating. In the turmoil, however, one important component has often been overlooked: housing.

With the expansion of Medicaid under the Affordable Care Act, millions of people across the country gained access to healthcare for the first time. Included in that number (but often forgotten) were many who gained housing or housing stability with the expansion.

Programs like Los Angeles’ Housing for Health program use Medicaid dollars to offer mental health counseling and substance abuse treatment alongside the housing it provides to formerly homeless residents. The two parts work together—patients often can’t keep up with counseling sessions or rehab without the stability of a home, and those who receive housing without supportive services too frequently end up back on the streets.

Supportive housing, which includes a variety of social services that people may need to live outside of an institution, became available to thousands more Americans with Medicaid expansion. These programs offer help to people with disabilities, mental illness, substance abuse issues, and those recovering from homelessness.

Under the Republican plan, however, Medicaid would be rolled back—and not just to pre-Obamacare levels. GOP leadership has pushed to end Medicaid as an entitlement, meaning that states would no longer receive funding based on residents’ needs. Instead, states would get a set amount of money for each resident on Medicaid. It would then be up to the states to decide what to do with that money.

The proposed amount per person is far less than what is needed, and it wouldn’t grow with rising costs. That would create a scenario in which state governments are forced to make more and more painful cuts each year, continually shrinking the number of services they provide to their most vulnerable residents.

And experts have predicted that supportive housing could be among the first services to go.

Disability activists and others have been relentless in organizing opposition to the bill, with actions happening almost every day at the Capitol. On Monday alone, 33 people were arrested in Senate buildings and offices while peacefully sitting in to demand that Republican senators kill the bill–not an atypical day.

Because of these efforts, both the initial Republican bill and a follow-up attempt to repeal the Affordable Care Act without a replacement have  failed. Yet activists warn against complacency. As unpopular as the draconian cuts are with the general public, they have broad support among Republican legislators and continued action will likely be necessary to prevent the bill’s revival.

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