Health
Health care or housing? More states are using Medicaid funds to help the homeless
In some states, the line between housing and health care is becoming increasingly blurred.
The Medicaid program is intended to offer government assistance with medical expenses for those with low incomes. Yet in at least 20 states, some of those funds are being allocated to social services — including housing support for the homeless.
While some tout the move as a means of alleviating the health conditions that can arise from poor living conditions, others say the funding will not solve the underlying problems.
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The federal government oversees the Medicaid program, yet each state can set its own benefits and eligibility requirements.
“States have broad flexibility in their Medicaid programs to create a program that is unique,” said Dr. Marc Samuels, founder and CEO of ADVI Health, a health care and life sciences advisory and consulting services firm headquartered in Washington, D.C.
In some states, Medicaid funds are being directed toward housing support for the homeless. (iStock)
“In general, states look to aid in housing on a temporary basis in an effort to focus on social determinants of health/population-based issues around serious mental illness or substance abuse disorders, and those with disabilities or receiving long-term care, high-risk pregnancy, or with a history of chronic homelessness,” he told Fox News Digital.
Which states offer Medicaid-funded housing?
At least 20 states today cover housing support services under their Medicaid program, according to the National Academy of State Health Policy (NASHP).
“There are five states — Arizona, California, New York, Oregon and Washington — that have received the approval from the federal government to cover short-term housing assistance through their Medicaid program using a specific type of waiver from the federal government (section 1115 demonstration waiver),” NASHP said in a statement provided to Fox News Digital.
“States have broad flexibility in their Medicaid programs to create a program that is unique.”
States can also offer this type of coverage through a program called Money Follows the Person.
This program “facilitates rebalancing states’ long-term care services and supports from institutional to community-based care,” the agency said.
A homeless woman begs for money along a city sidewalk. Her sign reads, “Homeless & Hungry – Please help. Thank you.” (Getty Images)
California has unveiled the most ambitious plan so far for state-funded housing support.
In 2022, Gov. Gavin Newsom announced a $12 billion, five-year plan to revamp its Medicaid program — called Medi-Cal — to include a range of social services outside the scope of medical care.
Those non-traditional services, officially called “in lieu of services,” include housing deposits, moving costs and rent, according to the state’s Health and Human Services Agency website.
California’s non-traditional medical services are officially called “in lieu of services.”
Nearly all the state’s public and private managed care health insurers participating in Medi-Cal will cover housing-related expenses.
In Sept. 2023, the Oregon Health Authority submitted a proposal for expanded Medicaid benefits that would include six months of rent assistance. If approved, the housing support would be available starting in Nov. 2024.
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Arizona’s Medicaid program — the Arizona Health Care Cost Containment System (AHCCCS) — also offers funds for a “limited number of housing units” for members, according to the state’s health services website.
Non-traditional services — officially called “in lieu of services” in California — include housing deposits, moving costs and rent. (iStock)
Arkansas, Massachusetts, Hawaii, New Jersey and Washington are among the other states that have launched Medicaid initiatives targeting homelessness, according to the National Academy of State Health Policy (NASHP).
Last month, New York was approved for a Medicaid expansion that will include housing support — and additional states are expected to follow suit.
Link between housing and health
Proponents of this funding believe there is a direct connection between housing and health.
The Medicaid and CHIP Payment and Access Commission (MACPAC), a non-partisan federal agency that makes recommendations to Congress about Medicaid programs, stated in a 2018 brief that “poor housing conditions can worsen health outcomes related to infectious and chronic disease, injury and mental health, and may also affect childhood development through exposure to harmful toxins such as lead.”
The agency added that people experiencing homelessness or housing instability may struggle to get health care for routine visits as well as necessary medical treatments.
“Data suggest that among those who are chronically homeless, the provision of supportive housing … led to a decrease in emergency department use,” MACPAC wrote in the brief.
While some tout the move to use Medicaid funds for housing as a way to alleviate the health conditions that can arise from poor living conditions, others say the funding will not solve the underlying problems. (iStock)
Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, said he does not think that providing housing is the answer to homelessness.
“It is a huge money drain on the state and it doesn’t solve the underlying problems of chronic mental health issues, excess drug use and the spread of infectious disease — not to mention the unemployment that drives all of it,” he told Fox News Digital.
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Siegel pointed out that housing in California is not currently affordable — an issue that affects everyone, not just the homeless.
“Using Medicaid to finance housing for the homeless bypasses the blue-collar workers who can’t really afford housing either,” he said.
The doctor does believe that shelter is a health issue, however.
“The vast majority of health variations are driven by factors completely unrelated to health care.”
“Without shelter, you are prone to many more medical issues, including dehydration, exposure to the elements, contagious diseases, malnutrition, drug use and the impact of mental illness,” he said.
“I like the New York City shelter system, which has worked well over the last three decades,” Siegel added. “It is starting to struggle now because of the influx of migrants with nowhere to go — which also represents part of the public health crisis.”
“Using Medicaid to finance housing for the homeless bypasses the blue-collar workers who can’t really afford housing either,” said Dr. Marc Siegel. (iStock)
Other doctors, however, said they are supportive of Medicaid funding going to housing costs.
“Many people think of health care as what happens in a doctor’s office, hospital or pharmacy — but what I can do for my patients as a doctor can quickly be undone if they don’t have food to eat or a roof over their heads,” said Colin Banas, M.D., chief medical officer for DrFirst, a health care technology company in Maryland.
“It’s refreshing to see that states such as California, Arizona, Oregon and Arkansas are allocating Medicaid funding in innovative and practical ways, especially as people experiencing homelessness are nearly twice as likely to have diabetes or experience heart attacks, according to the CDC,” he told Fox News Digital.
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Rather than using “scarce resources” for housing instead of traditional health care, Banas said he believes that an “additive approach” is ideal.
“Programs addressing homelessness should help us learn where interventions can have the greatest impact,” he said.
Homeless people stand with their belongings in front of an outpatient mental health clinic in Los Angeles, California, on Dec. 6, 2022. (FREDERIC J. BROWN/AFP via Getty Images)
Scott Shipman, M.D., executive director of the Institute for Population Health at Creighton University in Omaha, Nebraska, said the association of secure housing with better health is “widely understood.”
In an email to Fox News Digital, Shipman referred to Medicaid-funded housing as “a means of achieving better, and more stable, health while curtailing a vicious, often multigenerational cycle of costly recurring physical and mental health services that are exacerbated by prolonged housing insecurity.”
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When state governments pursue housing coverage through Medicaid waivers, they get a match of federal funding, Shipman noted.
“These programs do not shift funding away from medical services in favor of housing, but rather attract additional resources to meet housing needs, typically for those whose health is most directly at risk due to inadequate housing,” he said.
Shipman called for investments in addressing community-level social needs rather than simply pouring more money into “shiny new medical care technology,” which he said will lead to “overspending and disappointing results.”
“It doesn’t solve the underlying problems of chronic mental health issues, excess drug use and the spread of infectious disease.”
“The vast majority of health variations are driven by factors completely unrelated to health care,” he added.
To qualify for housing assistance, people must meet certain needs-based health criteria, including serious mental illness, disability, pregnancy or homelessness, according to NASHP.
Fox News Digital reached out to the Centers for Medicare & Medicaid Services as well as several state health agencies for additional comment.
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As snow blanketed parts of the U.S. this week, heart health experts have shared warnings of the physical strain shoveling can take — particularly for older adults.
A 2025 Mayo Clinic review found that just 10 minutes of heavy snow shoveling can push the heart to about 97% of its maximum rate. Exposure to cold air was also found to increase blood pressure and reduce coronary blood flow.
While there isn’t an official age that’s “too old” to shovel, some cardiologists recommend that individuals over 45 should exercise more caution to lower their chances of a cardiac event.
When to take caution
“While there’s no strict age cutoff, generally above the age of mid 40s and above, we tend to be a little more cautious — particularly in people who are less active [without] regular exercise,” Dr. Navjot Kaur Sobti, M.D., an interventional cardiologist at Northwell’s Northern Westchester Hospital in Mount Kisco, New York, told Fox News Digital.
Heart health experts have shared warnings of the physical strain shoveling can take — particularly for older adults. (iStock)
“Certainly in people who are above the age of 65 — and who have risk factors for heart disease, such as high blood pressure, high cholesterol, diabetes, obesity or sedentary lifestyle — we recommend being very, very cautious about shoveling snow,” she advised.
Dr. John Osborne, M.D., a practicing Texas cardiologist and volunteer for the American Heart Association, shared similar guidance for people older than 45, especially males over 65.
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“Unless you are in good cardiovascular shape and conditioned, it may be a good idea to ask someone for help,” he said in an interview with Fox News Digital.
The impact of snow removal is especially concerning for those with existing cardiovascular risks and a history of heart attack or stroke, according to the cardiologist. “People with these characteristics and those who have had bypass surgery or coronary angioplasty simply should not be shoveling snow in any conditions,” he said.
Just 10 minutes of heavy snow shoveling can push the heart to about 97% of its maximum rate, a 2025 Mayo Clinic review found. (iStock)
Osbourne said he often sees cardiac episodes in people who are typically sedentary and sit at a computer most of the day with little or no exercise. “Then once or twice a year, they go out and try to shovel the driveway after a heavy snowfall, and that unexpected exertion can unfortunately lead to tragedy.”
Hidden strain
The stress that is placed on one’s heart while shoveling snow is similar to what occurs during a cardiac stress test, Sobti pointed out, and may even exceed it.
Cold temperatures can cause blood vessels to constrict and blood pressure to spike — which, coupled with existing hypertension and the exertion of lifting snow, can significantly tax the heart, she warned.
“It’s almost like an at-risk person is putting themselves through an unsupervised maximal exertion stress test without a cardiologist actively monitoring them,” Sobti told Fox News Digital.
The stress that is placed on one’s heart while shoveling snow is similar to what occurs during a cardiac stress test. (iStock)
In addition to the exertion of shoveling, frigid temperatures can also strain the heart. Recent research has shown that cold exposure accounts for nearly twice as many cardiovascular deaths as heat exposure, including heat exhaustion.
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That study, published in the Annals of Internal Medicine last month, also found that those over age 65 had higher rates of temperature-related deaths.
“So the risk is very, very high,” Sobti cautioned. “It’s really that sudden rise in blood pressure coupled with the physical stress of snow shoveling itself.”
Safer shoveling tips
The cardiologist said it’s ideal to have someone else help with snow removal — but if you do choose to use a shovel, she recommends pacing yourself and using a “pushing or sweeping” motion instead of heavy lifting.
Recent research has shown that cold exposure accounts for nearly twice as many cardiovascular deaths as heat exposure. (iStock)
To protect against the cold, Sobti also recommends covering your mouth, nose and extremities, wearing a hat and gloves, and using extra caution in windy conditions.
Using an automated snow blower can still raise the heart rate — up to 120 beats per minute, compared to 170 while shoveling, the American Heart Association states on its website.
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It is also important to be aware of any symptoms of a potential cardiac issue while shoveling, Sobti emphasized.
If a person starts to experience warning signs such as chest pain, shortness of breath, a racing heart or palpitations, those should not be ignored.
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Even if the symptoms resolve after a few minutes, a person “could still be experiencing symptoms of a heart attack” and should call 911 for evaluation, Sobti said.
“It’s better really to be safe than sorry.”
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More than three-quarters of the global population is falling short on omega-3 intake, a nutrient gap that may increase the risk of heart disease, cognitive decline, inflammation and vision problems.
That’s according to an analysis published in Nutrition Research Reviews, in which researchers from the University of East Anglia, the University of Southampton and Holland & Barrett analyzed omega-3 intake patterns across multiple countries and age groups.
The review found that 76% of people worldwide are not meeting the recommended levels of two omega-3 fats that are essential for heart health: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
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The analysis considered recommendations from global health authorities and assessed how closely populations follow them.
Most adults should aim for at least 250 milligrams of EPA and DHA per day, though actual intake is far lower in many regions, according to the researchers.
A new study found that 76% of people fall short of their recommended omega-3 intake. (iStock)
To explore the health implications of low omega-3 intake, Fox News Digital spoke with Michelle Routhenstein, a New York–based preventive cardiology dietitian at Entirely Nourished.
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Low omega-3 levels can have a noticeable impact on heart health, cognitive function and inflammation throughout the body, the expert confirmed.
Low intake can also increase the risk of heart attacks and sudden cardiac death, she added. It’s also associated with higher triglycerides, irregular heart rhythms and plaque in the arteries.
Most adults should aim for at least 250 milligrams of EPA and DHA per day, researchers say. (iStock)
Inadequate omega-3 levels have also been linked to changes in brain function, including faster cognitive decline, a higher risk of Alzheimer’s disease and increased rates of depression.
Routhenstein noted that low levels may also worsen inflammation in autoimmune conditions such as psoriasis, and can negatively affect eye health, since omega-3s play a key structural role in the retina.
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To improve omega-3 levels, the expert said it’s important to understand how much is needed and where to get it.
“The richest dietary sources of EPA and DHA are oily fish, such as salmon, mackerel, sardines, herring, trout and anchovies,” Routhenstein told Fox News Digital.
Oily fish, such as salmon, are among the richest natural sources of omega-3s. (iStock)
Many people benefit from eating oily fish more frequently, often three to four times per week, Routhenstein noted. For individuals who do not eat fish regularly, supplements can help raise EPA and DHA to healthier levels.
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For those taking omega-3 supplements, dosing should be based on lab results, medications, omega-3 levels and overall medical history, according to Routhenstein. Moderate, quality-controlled supplements are generally considered safe for most people.
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There is also some evidence supporting prescription-strength omega-3 products.
“High-dose EPA, such as 4 grams per day of icosapent ethyl, has been shown to reduce major cardiovascular events in certain high-risk populations, while similar doses of mixed EPA/DHA have not consistently shown the same benefit,” Routhenstein said.
Omega-3 dosing should be individualized based on lab data, medication use, current levels and overall medical history. (iStock)
Testing omega-3 levels can also help determine whether intake is adequate. The omega-3 index, a blood test that measures EPA and DHA in red blood cells, is considered one of the most reliable ways to assess status.
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“Levels around 8% are associated with lower cardiovascular risk, while levels below approximately 4% are considered low,” Routhenstein said.
Understanding baseline levels can help guide more personalized decisions about diet and supplementation.
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Those who are unsure about their omega-3 status or whether supplementation is appropriate should speak with a healthcare provider to determine the best approach.
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As winter weather moves in, cozy essentials like scarves, plush throws and heated bedding become everyday comforts.
But dermatologists caution that these cold-weather favorites can secretly undermine skin health — trapping sweat and bacteria, causing irritation and exposing the skin to excess heat.
Choosing the right materials for wellness — and using them safely — can make a big difference.
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Here are five winter must-haves and gift ideas, with expert tips on how to keep skin healthy and happy while staying warm this season.
Soft scarf, $19.99, Amazon.com
Scarves made of natural fiber, like this one that is 100% cotton, may help if you’re prone to irritation. (Amazon)
A soft scarf is a staple for cold days and an easy way to elevate a winter outfit.
Yet, if breakouts are appearing along the neck, jawline or chest, that favorite accessory may be part of the problem.
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“You should wash your scarf as often as your clothes to prevent breakouts,” Annabelle Taurua, a beauty expert at Fresha, a beauty and wellness booking platform headquartered in London, told Fox News Digital.
Cotton is a better choice than polyester, she also noted, as it’s more breathable and allows sweat to evaporate.
Fluffy blankets, $28.97, Potterybarn.com
Fluffy blankets make for perfect cozy days at home, but their soft fibers can trap sweat, oils and dead skin — which can clog pores and encourage bacteria growth. (Pottery Barn)
Fluffy blankets make for perfect cozy days at home, but their soft fibers can trap sweat, oils and dead skin, which can clog pores and encourage bacteria growth.
Rough textures or infrequent washing can also irritate sensitive skin and worsen breakouts.
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“Regularly wash your blankets, especially those made from synthetic or fluffy materials, to remove built-up oils and dirt,” Taurua advised.
She recommended breathable materials like cotton or linen, as well as hypoallergenic options for anyone prone to irritation.
Good set of sheets, $49.99, Amazon.com
Much like scarves, natural fibers are the way to go for your linens to avoid irritation. (iStock)
Cold weather makes lingering in bed especially tempting, but lying on unwashed bedding can worsen acne.
Pillowcases and sheets quickly collect oil, bacteria and dead skin cells, which transfer directly onto the face.
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“Washing bedding frequently is important,” Taurua said. “You should aim to change and wash your pillowcases every two to three days and your sheets at least once a week.”
Heated blanket, $33.99, Walmart.com
Heated blankets are a great way to stay warm during the winter. (Walmart)
When using a heated blanket, start with the lowest heat setting and limit use, said Taurua.
“Once you’re warm, switch to a regular blanket,” she advised.
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She also said it’s best to avoid direct contact for long periods to reduce irritation.
Hot water bottle, $12.99, Amazon.com
A traditional winter staple, hot water bottles offer quick comfort — but they come with risks similar to heated blankets, including burns, scalding and long-term heat-related skin damage.
Hot water bottles should never be filled with boiling water, experts advise. (Amazon)
“Never fill a hot water bottle with boiling water,” Taurua said.
“Only use hot, not boiling, water, and fill it to a maximum of two-thirds.”
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She recommended wrapping the bottle in a towel or cover to avoid direct skin contact and limiting use to around 20 minutes.
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