Oregon is prepping to launch an unusual part of its 2022-2027 federal Medicaid Demonstration waiver, which will allow it to use Medicaid dollars to address social and lifestyle factors that can often dramatically affect health, lower quality of life and increase medical costs. 

According to a November 8 article in the Oregon Capital Chronicle, “the benefits are part of the state’s five-year Medicaid program, which won federal approval to spend tax dollars on housing, food and climate-related needs, like air conditioners, in addition to the traditional medical and dental benefits.” 

New services will be phased in with housing needs targeted first. According to the Oregonian article by Ben Botkin, “state officials have decided first to help those most at risk of ending up on the streets.” For some of the 125,000 people who are potentially eligible for help, this may mean one-time payments to cover rent or utilities or a security deposit. 

That program won’t begin until November 2024, but plenty of planning and cross-departmental collaboration will be needed between now and then. 

Of course, this effort isn’t going to provide full salvation for people who may lose their homes. A variety of other approaches will be needed to keep people from ending up on the streets as well. As Andrea Bell, director of Oregon Housing and Community Services told the newspaper, “We know that there’s going to have to be a part two, that’s going to come behind that six-month rental assistance for most members,” 

In Oregon, housing is just the first topic to be covered through the waiver. A focus on food assistance will commence the following year, starting in January 2025. This all adds up to a very promising approach to deal with “Social Determinants of Health” -- the multiple factors that affect health and are not normally addressed by the medical establishment.

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