Medicaid Eligibility Among Homeless and Nonhomeless VA Service Users
This study explores the impact of Medicaid expansion on VA service users, estimating eligibility rates and comparing characteristics between homeless and nonhomeless individuals. Results show potential advantages and risks of cross-system care.
Medicaid Eligibility Among Homeless and Nonhomeless VA Service Users
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Presentation Transcript
Homeless and nonhomeless VA service users likely eligible for Medicaid expansion Jack Tsai, PhD; Robert A. Rosenheck, MD
Aim • Use administrative data on 2010 VA service users to: • Estimate how many homeless and nonhomeless VA service users may be eligible for 2014 Medicaid expansion (LEME). • Compare LEME and not LEME by homeless status on sociodemographic characteristics and medical and psychiatric diagnoses. • Relevance • Results will estimate VA service users to be affected by Affordable Care Act’s (ACA’s) Medicaid expansion and explore their characteristics and health needs.
Method • Analyzed administrative data on 3.8 million VA service users under age 65 in 2010 to identify number and characteristics of those who are homeless vs nonhomeless and LEME.
Results • 1.2 million (21%) VA services users are LEME if all states implement expansion. • Homeless service users twice as likely to be LEME than nonhomeless users (64% vs 30%). • Both homeless and nonhomeless LEME VA service users were physically healthier but more likely to have substance use disorders and posttraumatic stress disorder than those not LEME.
Conclusion • Many VA service users are LEME, particularly those who are homeless and/or have mental health needs. • Cross-system use of VA and Medicaid-funded services may be advantageous for veterans with extensive medical and psychiatric needs but also risks fragmented care. • Information and education for VA clinicians and patients about possible implications of ACA are important.
