A new study found that the Medicaid expansion in California led to fewer housing evictions, concluding that the expansion can help with housing stability.
The results from the study published in the journal Health Affairs comes as the Trump administration is fighting for changes such as work requirements that could curb enrollment in the Medicaid expansion.
Researchers examined eviction rates in California before and after the state’s early adoption of Medicaid. California allowed counties to sign up for expansion in 2011 and 2012, before the expansion fully went online in 2014. Early expansion was associated with a decline in evictions, with 24.5 fewer evictions per month in each expansion county compared to a pre-expansion average of 224, the study said.
“These results imply that for every thousand new Medicaid enrollees in California, Medicaid expansion was associated with roughly 22 fewer evictions per year,” the authors said.
The reason for the decline in evictions was likely due to Medicaid’s impact on curbing medical debt and costs.
“Medicaid may mitigate the risk of eviction directly by reducing the cost of medical care and indirectly by protecting earning potential through better health,” the study said.
The state also saw a reduction in the use of payday loans after the expansion, as coverage could have helped families “avoid being sent to court for an eviction or being evicted by allowing tenants to come to a financial agreement with their landlords,” the authors said.
Researchers compared the eviction rates for 51 California counties that did expand against the rates for 235 counties in other states that didn’t expand Medicaid from 2008 through 2013.
The authors found a 2.9-percentage-point decline in evictions per capita in expansion counties compared to non-expansion counties over the study's timeframe.
The Medicaid expansion went online in 2014 but a 2012 Supreme Court ruling meant that states had to decide on whether to adopt it. As of Aug. 1, there are 14 states that have not adopted the expansion and three states have adopted but not implemented it, according to data from the think tank Kaiser Family Foundation.
The authors said they hope the study’s findings will inform policymakers that are considering policies that could impact enrollment in Medicaid.
The Centers for Medicare & Medicaid Services has approved waivers from Indiana, New Hampshire, Arkansas and Kentucky to implement work requirements for certain Medicaid expansion beneficiaries. However, a federal judge has blocked implementation of the requirements in Arkansas and Kentucky, arguing that CMS didn’t consider potential coverage losses when approving the waivers.
CMS also recently shot down requests from Idaho and Utah to implement a partial expansion of Medicaid. Voters in both states passed ballot measures last year calling for full expansion.