and Joan Alker
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.