Massachusetts is asking the Biden administration for permission to use money from Medicaid, the health program for low-income and disabled Americans jointly funded by the states and the federal government, to pay for temporary housing for homeless families and pregnant women, including newly arrived immigrants.
It’s only the latest request by states to spend money specifically earmarked for providing health coverage for the poor on, well, something that is not health coverage for the poor.
Housing is not healthcare, and “undocumented immigrants” aren’t eligible for federally funded health coverage, including Medicaid, under federal law.
It’s absurd to turn Medicaid into a slush fund for the progressive Left’s latest policy priorities.
Already, 19 states have federal permission to spend Medicaid dollars on eligible participants’ housing, food, or other “social determinants of health.” Five states have programs to provide “home delivered meals or pantry stocking” to eligible Medicaid enrollees, and, as of January, seven states have approved the use of Medicaid funds for “gun violence prevention.”
The Bay State’s new proposal would make homeless families and pregnant women, including those not in the country legally, eligible for six months of free housing and “supportive services,” such as “referrals to medical, social, and educational services.”
These programs supposedly address “social determinants of health care” and are thus worthwhile uses of Medicaid funding, according to Massachusetts officials. Proponents argue that “food is medicine” and “housing and health are intertwined.”
It’s a slippery slope. Warm clothes can prevent hypothermia. Should Medicaid dollars buy a winter coat for every low-income person in Massachusetts?
The progressive Left downplays the cost of “health-related” programs. It claims the projects are “budget neutral” for the federal government, since states don’t get additional federal funding and can’t allocate more than 3% of their total Medicaid spending toward them.
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That argument misses the point. Medicaid is already too big. As of November 2023, nearly 86 million people were covered by Medicaid or the related Children’s Health Insurance Program. That’s roughly one-fourth of the U.S. population. The program’s costs topped $805 billion in 2022. Based on recent trends, Medicaid spending will exceed $1 trillion in 2028.
That level of spending is not sustainable. The federal deficit last year exceeded $1 trillion. Net interest on the debt was $659 billion. State and federal officials need to rein in Medicaid spending — not use it to pay for everything from groceries to housing for the homeless.
Sally C. Pipes is president, CEO, and Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020). Follow her on X, formerly Twitter, @sallypipes.
