Programs that helped Medicaid patients with housing deposits, medical transportation, wheelchair ramps, and even fruit and vegetable prescriptions are now at risk. The Trump administration is reversing a Biden-era push to use Medicaid for social services that address the root causes of poor health.
At least 24 states had adopted the approach, offering services to help prevent costly emergency care by improving housing and food access. Experts say social factors like these drive most health outcomes, especially for people with chronic illnesses.
The Centers for Medicare & Medicaid Services (CMS) announced in March it was rescinding federal support for these experimental benefits, arguing they go beyond Medicaid’s core mission. “These services should be handled by existing federal programs,” said CMS spokesperson Catherine Howden.
But the Trump administration is also proposing cuts to those very programs — including food aid and housing support — raising concerns about deeper health impacts.
Health experts warn the rollback could worsen conditions like diabetes and heart disease, raise costs, and increase homelessness. “It will just lead to more death, more suffering, and higher health care costs,” said Dr. Margot Kushel, a San Francisco physician and homelessness researcher.
The administration plans to evaluate future Medicaid waivers for social services on a case-by-case basis. Meanwhile, it is pushing to tie Medicaid benefits to work requirements, putting coverage for millions at risk.
“They’re saying Medicaid should only cover basic medical care,” said UCLA health policy expert Mark Peterson. “But most specialists disagree — social factors are key to health.”
Although states haven’t been formally ordered to shut down their programs, experts expect many of them to lose federal approval once their current five-year waivers expire.
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