Since 1985, Care for the Homeless has consistently found that approximately fifty percent of the homeless people receiving the health care arranged by us do not have Medicaid, a joint federal and state health insurance program for low-income people. Given the fact that Medicaid is a means-tested program, coupled with the extreme poverty of homeless people, we can assume that most of these people are eligible for Medicaid in New York State. Many homeless people do not apply for Medicaid because they do not know they are eligible; because they are distrustful or fearful of negotiating the system, which can baffle even the most determined; or because they have had and lost Medicaid in the past and are frustrated by a system that seems to haphazardly drop their enrollment.

Without Medicaid, homeless people have limited access to the full range of health services. With Medicaid, they can be mainstreamed into the health care system, which in turn may promote more independent functioning.

In 2001, Care for the Homeless published a report that documented some reasons why eligible New Yorkers do not have Medicaid. We found that while the intent of the Medicaid program is to serve as the safety net for health care coverage, over the years the actual practice of the application process has become a barrier to many who appear to meet program eligibility standards.

Care for the Homeless works with many national, state-wide, and city-wide agencies and coalitions, to advocate for a simple and straight-forward Medicaid application process. In fact, Care for the Homeless has offered programmatic solutions to both the City and the State that would create a public health insurance application process similar to that of Disaster Relief Medicaid.