Legislation introduced to back state Medicaid programs in addressing social determinants

Capitol building in Washington
A bipartisan coalition on Capitol HIll introduced a measure to provide grants and technical assistance to state, local and tribal governments that want to devise evidence-based approaches to addressing social determinants of health. (Photo by rarrarorro/iStock/Getty Images Plus/Getty Images)

A bipartisan coalition from the U.S. House of Representatives introduced new legislation Thursday aimed at improving resources—including grant funding—to better address social determinants of health (SDOH) for state Medicaid populations.

The measure will provide grants and technical assistance to state, local and tribal governments that want to devise evidence-based approaches to programs and services. It will help officials, states and communities as they devise strategies to leverage existing programs that address food, housing, transportation and workforce issues, officials said.

“This bill will give state and local officials the resources they need to get beyond the silos and develop innovative approaches to complex problems,” Krista Drobac, co-chair of Aligning for Health, said in a statement. The coalition includes health insurers, providers and vendors.

The Social Determinants Accelerator Act was introduced by Reps. Cheri Bustos, D-Illinois; Tom Cole, R-Oklahoma; Jim McGovern, D-Massachusetts; and Cathy McMorris Rogers, R-Washington. SDOH include factors such as access to housing, food and transportation that research has linked to the prevention and management of many health conditions including diabetes, asthma and heart disease.

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In a press conference, Bustos noted that social determinant programs are especially important to rural congressional districts such as her own in Illinois, where 60% of the towns contain 1,000 people or fewer. As someone who worked in healthcare for 10 years and as a healthcare reporter, Bustos saw firsthand "what a powerful impact" social determinant programs can have on a person's health and well-being.

Specifically, the legislation (PDF) would:

  • Create an interagency technical advisory council that includes experts from the federal departments of Housing and Urban Development, Labor and Agriculture—as well as state and local government officials and community-based organizations.  
  • The Council would work with the Centers for Medicare & Medicaid Services to award up to $25 million in grants to state, local and tribal government to develop SDOH plans. These plans would target high-need Medicaid patients, identify key outcomes for interventions and include a plan for linking data across programs in order to measure the impact of the new approach.
  • Finally, the council would provide technical assistance to grantees to help them implement their plans by identifying opportunities and strategies for blending funds and designing evaluations.

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At least 20% of the funding will be reserved for grants serving rural populations.

“We know that even if quality care is available, social determinants often prevent individuals from being able to access healthcare or achieve health goals," Tom Nickels, executive vice president at the American Hospital Association, said in a statement. "These social determinants of health often include safe and stable housing, access to healthy food, transportation, social connections, safety and environmental exposure.”