If you were led blindfolded a few blocks east from Los Angeles’ grand City Hall, you would know instantly when you entered Skid Row.
There is the pungent smell of urine and marijuana smoke, and the sound of music and easy laughter — a carnival rising out of misery.
This is the chaos that Chris Mack plunges into on most days. Once homeless himself, Mack is an outreach worker for the JWCH Institute’s Center for Community Health, a free clinic in the heart of Skid Row.
Mack is part of a concerted push to enroll the nation’s homeless in Medicaid. As of January, the health insurance program that’s jointly funded by federal and state governments is being opened for the first time to all poor adults, not just those with disabilities or dependent children.
The outreach is important, homeless experts say. In addition to safe permanent housing, regular medical care is a critical intervention for getting lost lives back on track.
“A person who is not feeling very well can’t behave or perform very well,” Mack says, “so I think health care is primary.”
The Medicaid expansion was a central provision in the Affordable Care Act, the federal health care law. But after the Supreme Court declared the expansion optional for states, rather than mandatory, 26 states and the District of Columbia have chosen to do so. Even without all the states participating, some 9 million people are expected to enroll in Medicaid across the country, and 1.2 million homeless people could be newly eligible for coverage.
Homeless advocates have cheered the expansion. Men and women living on the streets and in shelters will be able to see a doctor regularly, keep prescriptions filled to treat their asthma, diabetes and schizophrenia, and get referrals to private specialists for lingering ailments.
by Sarah Varney, NPR