Eviction, Healthcare Utilization, and Disenrollment Among New York City Medicaid Patients

Overview

The US is experiencing a housing affordability crisis. Families that lack access to safe, affordable and stable housing face increased risk of eviction, especially in cities, where the rent burden is most severe. Research suggests that evictions worsen material hardship, can force families into lower-quality housing in more disadvantaged neighborhoods, and erode mental health. While evictions have been linked to negative physical health outcomes, few studies have analyzed their impact on healthcare utilization and access. To fill this gap, researchers Gabriel L. Schwartz, Justin M. Feldman, Scarlett S. Wang, and Sherry A. Glied linked 2017 New York City eviction data to New York State Medicaid records to test whether evictions interrupt healthcare access or if the hardship caused by evictions lead to higher healthcare utilization.

Findings

Eviction drives increased healthcare spending while disrupting healthcare access. The researchers found:

• NYC evictions in 2017 were associated with 63 percent higher odds of losing Medicaid coverage, fewer prescription fills, and lower odds of spending on healthcare.
• Evicted patients who did access care generated 20% more in costs and had more acute care visits, compared to people who were not evicted.
• NYC Medicaid patients who were evicted were more likely to be male, Black or Hispanic, Bronx residents, and US citizens.

Implications for Policy and Practice

These results suggest integral links between housing and health. Given previous research that found Medicaid expansion lowered eviction rates, this new evidence shows eviction and Medicaid disenrollment may occur in cycles, causing disadvantage among vulnerable communities to accumulate. Policy and practice aimed at preventing evictions may improve access to care and lower Medicaid costs.