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Illustration: Sarah Grillo/Axios

States are increasingly using their Medicaid programs to focus on addressing social determinants of health, like access to housing and food, as a way to make health care more comprehensive and cost-effective.

The big picture: These state Medicaid efforts are part of a growing recognition that improving overall population health — and health equity — will have to include interventions beyond the traditional health care system.

Growing awareness of the connection between social factors and health has coincided with the Affordable Care Act's Medicaid expansion, and an increased focus on making sure health insurance is effective.

  • For example, people's nutrition suffers when they don't have transportation to a grocery store or access to healthy food options — and that leads to adverse health consequences.

States are taking different approaches to addressing these factors, and are doing so through waivers, optional Medicaid authorities and their contracts with managed care organizations.

  • "I wouldn’t call it a 'blue state' trend, since there are lots of states looking at this, even red ones," said Matt Salo, executive director of the National Association of Medicaid Directors. "I would call this a focus on the social determinants of health and how Medicaid can provide and/or pay for non-traditionally medical services like housing, food, and efforts to address social isolation."

How it works, per a Kaiser Family Foundation brief:

  • Oregon and Colorado have both established regional organizations that focus on integrating social, behavioral and physical elements of health. One Colorado organization uses Meals on Wheels to help Medicaid enrollees discharged from the hospital get food.
  • Texas has installed refrigerators in some homeless shelters so people can refrigerate their insulin.
  • A California waiver increases hospital coordination with social services and welfare offices.
  • The Louisiana Department of Health is working with the state housing authority to reduce homelessness and institutionalization of people with disabilities.

Where it stands: While the Obama administration was very supportive of these efforts, the Trump administration is devoting more attention to other parts of its agenda, like Medicaid work requirements. But states are still active, and the Trump administration is approving state proposals along these lines.

Go deeper

Rep. Rice demands Cuomo resign after 3rd woman accuses him of misconduct

New York Gov. Andrew Cuomo during a February news conference in New York City. Photo: Seth Wenig/POOL/AFP via Getty Images

Rep. Kathleen Rice (D-N.Y.) on Monday evening called for New York Gov. Andrew Cuomo (D) to resign, after a third woman accused him of inappropriate behavior.

Driving the news: Anna Ruch, a former member of the Obama administration and the 2020 Biden campaign, told the New York Times Monday that Cuomo asked to kiss her at a New York City wedding reception in September 2019.

Scoop: Inside the GOP's plan to retake the House

House Minority Leader Kevin McCarthy. Photo: Elijah Nouvelage/Bloomberg via Getty Images

House Republicans will reclaim their majority in 2022 by offering candidates who are women, minorities or veterans, a memo obtained by Axios says.

Why it matters: The document, drafted by a super PAC blessed by House Minority Leader Kevin McCarthy, names top Democrats to target — Jared Golden of Maine, Matt Cartwright of Pennsylvania and Ron Kind of Wisconsin — and the type of Republican candidates to beat them.

4 hours ago - Politics & Policy

Scoop: Trump talked out of early Ohio endorsement

Jane Timken at a 2017 Trump rally. Photo: Kyle Mazza/NurPhoto via Getty Images

Donald Trump had to be talked out of making an early endorsement in Ohio's 2022 U.S. Senate race, a sign of his eagerness to reengage politically, people familiar with the conversations tell Axios.

What we're hearing: The former president discussed endorsing former state GOP chair Jane Timken last week during a meeting at Mar-a-Lago with RNC Chairwoman Ronna McDaniel, but top advisers — including Donald Trump Jr. — urged him to wait.