By: Tara Mancini and Joan Alker


Editor’s Note:  Like so many others, we were touched by the story of Samantha Garvey, an inspirational homeless student from New York who is a finalist in the Intel Science Talent Search competition.  She was invited to attend President Obama’s State of the Union address tonight as the guest of a Member of Congress.  In her honor, we post this blog about the need to improve efforts to connect homeless children with health care coverage. 

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Recently, we reported on the low rates of children without health insurance as being a bright spot in the bleaker landscape of poverty rates that have risen exponentially.  However, we know that poverty permeates all facets of life, and a new report from the National Center on Family Homelessness (NCFH) shows just how far-reaching those effects can be, especially when exacerbated by an economic recession. “America’s Youngest Outcasts 2010,” the first state-by-state report card on child homelessness reveals that one in 45 children, or 1.16 million are homeless each year in the United States. That is a 33 percent increase from 2007.

The estimates from NCFH are larger than other current data from the Department of Housing and Urban Development (HUD) because they use different data sources and NCFH’s definition of homelessness includes more than just those families living on the street or in shelters. Family homelessness often shows up in different ways than adults who do not have or are not living with their children.  For example, NCFH counts those families who are “doubled up” – they have moved in with others – as well as families living in motels, hotels, trailer parks, camping grounds, and abandoned structures. This more inclusive definition is a result of NCFH’s use of data from the Department of Education, which collects information annually during the school year, as mandated by federal law.

While access to health insurance is not a focus of the study, it acknowledges the disproportionately high rates of chronic health conditions and previous exposure to domestic violence experienced by homeless children. Virtually all homeless children, unless they are undocumented, should be eligible for Medicaid. Yet many may not be enrolled particularly because of their unstable housing arrangements. We know that the poorest children, those below 50 percent of the FPL, have higher rates of uninsurance.  (Read our report on children’s 2010 uninsurance rates.). 

Enrolling homeless children is not easy; administrative requirements can serve as barriers to enrolling or retaining coverage, and as reported in the survey, 97% of homeless children move as many as three times in a year.  Many homeless persons seek treatment at the emergency room, which is then incurred by the hospital.  This should serve as a useful reminder for state and federal legislatures that the costs of homelessness can add up, and outreach and enrollment efforts that target this population make a lot of sense. (Read about Tennessee’s shelter enrollment project.) 

Ending family homelessness will only be possible by increasing access to quality, affordable housing.  Just as important is the need to offer comprehensive services and supports to families that address the broad spectrum of issues created by poverty and homelessness. Ensuring that homeless children are all enrolled in Medicaid is a good place to focus some energy.

 

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