As we near the end of the year and face the holidays during a surging pandemic, many people will struggle with isolation and sadness at being away from loved ones. Additionally, COVID-19 has unleashed a series of crises that are interrelated, and is impacting seemingly every facet of our society, including the ability of people to meet basic needs, such as food and housing security. The pandemic has destabilized many people in America and left an overwhelming number of families at risk of being evicted. 

Even before the pandemic, people of color were at greater risk of being evicted. Structural racism and discriminatory housing and lending practices are responsible for trends like the widening gaps in homeownership rates between white and Black households. The COVID-19 pandemic and the subsequent economic crisis have further exacerbated the issue of likely evictions, particularly among communities of color, as the country faces crippling levels of unemployment. Trends have indicated that people of color are more likely to experience financial risks associated with COVID-19 by either becoming unemployed or experiencing a loss of income. This is largely due to higher rates of people of color in frontline industry jobs that have been affected by the pandemic.  

With the rising levels of unemployment comes a marked increase in Medicaid enrollment as part of the countercyclical nature of Medicaid — during economic crises, people are more likely to become unemployed and lose their employer-sponsored health insurance, thereby making them newly eligible for Medicaid. Various housing security and public health emergency (PHE) provisions were put in place to counter potential upheavals in housing and health care. However, these protections, particularly housing protections, are set to end soon with no plans to extend or mitigate the impending damage. Medicaid beneficiaries, as low-income earners, are especially susceptible to the impending housing crisis once the current eviction prevention measures and PHE protections expire. We must proactively consider what the end of such protections means for Medicaid beneficiaries, keeping in mind that the economic crisis will, most likely, continue to drag on. 

The COVID-19 PHE and housing protections range from eviction moratoriums passed as part of the CARES Act to the Medicaid Maintenance of Effort (MOE) requirement included in the Families First Coronavirus Response Act (FFCRA) laid out in greater detail in our latest issue brief. Each of these provisions offers some protection but is not sufficient to ensuring housing security for those who should be focusing on how to prevent themselves and their loved ones from contracting the virus. Further, as a vaccine is now within reach, and development and dissemination will most likely begin in 2021, the public health emergency declaration, tied to many protections related to health and housing, will come to an end. 

Health advocates can play a key role in ensuring no matter when housing and health protections end – perhaps even at different times—that no person is left without recourse and rightful access to health benefits. At the highest level, the incoming Biden-Harris administration must work to ensure a smooth transition when unwinding the public health emergency. This will be paramount for family security. Similarly, there are current tools that can be deployed to support people in transition, securing their access to health. These include 12-month continuous Medicaid eligibility for adults, ex parte renewals by Medicaid agencies, emergency rental assistance and eviction prevention measures. 

Learn more about the unique challenges of the interaction between housing and Medicaid here.  

For many, the encouraging news of the vaccine trials means that there is light at the end of the tunnel, but for others it means that the protections that have helped them stay afloat during the pandemic will soon be ending. Equitable policies are the best standard to ensuring that millions of people do not suffer from housing insecurity and lack of access to necessary health care coverage as we take on the aftermath of the COVID-19 pandemic.