As COVID-19 intensified early last year, we saw major spikes in unemployment across the nation. In response, the federal government instituted an eviction moratorium on March 27, 2020; however, the federal eviction moratorium expired on July 31, 2021, and the new moratorium put in place by President Biden was recently overturned by the Supreme Court, citing the need for Congress to specifically authorize the moratorium for it to continue.
The most recent Census Bureau survey data show that 11.4 million American adults reported being behind on rent.1 As a result, millions of Americans are at risk of homelessness if they are unable to access assistance, foreshadowing a major health care crisis given the connection between stable housing and better health. Even if 99% of those behind on their rent resolve the issue, 114,000 more people would still face homelessness — a 20% increase nationally. And just as COVID-19 has disproportionately impacted communities of color, housing insecurity is no different, further exacerbating already dramatic health inequities.
Housing is health care
The connection between stable housing and improved health is enormous, and the evidence is clear. Individuals and families experiencing homelessness have worse health outcomes and often experience premature mortality as a result. The National Health Care for the Homeless Council reports that individuals who experience homelessness die on average 12 years sooner than the general U.S. population. Homelessness is connected to poor physical and mental health outcomes and is associated with high rates of substance abuse, mental illness and other chronic and often disabling conditions.2 And people experiencing homelessness disproportionately use emergency departments and in-patient hospitalizations, often with no improvement to their health.
The looming eviction crisis is a precursor to an exacerbated health care crisis.
We know that providing access to safe, affordable housing improves health outcomes for people experiencing homelessness. And for people with chronic and acute health care needs, providing housing aligned with health care and social services is critical to maintaining housing and improving health. Having a safe, affordable place to live also reduces unnecessary and inappropriate use of health care services.
Influx of federal aid
The American Rescue Plan provides an unprecedented opportunity to get people off the streets and into housing, while at the same time connecting them to the health care they need.3 It provides $21.5 billion in emergency rental assistance funds, $10 billion in homeowner assistance funds, and $5 billion for emergency housing vouchers, among other assistance. This is on top of original Coronavirus Aid, Relief, and Economic Security (CARES) Act funding from December 2020. Distribution of these funds is still underway, so there is an immediate opportunity to work with states, localities and local Continuum of Care programs to align rental assistance with primary and behavioral health care for the most underserved people in our communities. If people experiencing homelessness with complex health needs can’t access health care supports, their ability to maintain housing is unfortunately low.
Focus on those most in need
While there is a large amount of funding to address the housing crisis, it can help only so many people. We urge communities to focus on providing resources to those most in need, including people experiencing homelessness, individuals with disabilities and those with chronic, complex care needs. We recognize this is not easy. To achieve this goal, housing agencies need to partner with health care providers and community-based organizations to ensure people get the health and social supports they need. If we don’t work together to focus on the most vulnerable, we risk having an even larger number of people facing homelessness.
We stand ready to partner
At UnitedHealthcare Community & State, we stand ready to partner with the housing community to ensure that people who receive rental assistance also get the health care they need to stay in their housing and thrive in their communities. We are engaging with cities, counties and Continuum of Care programs, and we are cultivating and building off of existing partnerships to support this mission. We can provide assistance to housing agencies in many ways, including:
- Developing data sharing agreements to identify overlap in populations
- Connecting people to primary and behavioral health care services
- Financing housing-related tenancy supports
- Providing care and case coordination
- Sharing outcomes and impact through analytics
Partnering with the housing community provides an extraordinary opportunity to align resources and capabilities to improve health outcomes for some of our community’s most vulnerable populations. Let’s work together to provide housing and health care to those most in need.
Read more from Andy McMahon and Stephanie Wilkinson
