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Health

Health insurers take on the affordability crisis — in housing

Health insurers are investing hundreds of millions of dollars into building new affordable housing units.

Why it matters: The housing affordability crisis is a major health care concern, since housing instability is tied to poorer health. Insurers say their investments will translate to healthier communities, which would also mean less costly enrollees.


  • It also comes as the federal government encourages Medicaid experiments that help low-income enrollees cover housing costs.

Driving the news: Centene, the nation's largest Medicaid insurer, last month announced its philanthropic arm is partnering with an affordable housing developer to invest roughly $900 million in new housing in eight states.

  • UnitedHealth Group last month said its investment in affordable housing has surpassed $1 billion, creating more than 25,000 homes for housing-insecure people since 2011.
  • Other major insurers like CVS Health, Elevance, Humana, and Kaiser Permanente have additionally put millions into housing developments in recent years, sometimes partnering with hospitals and health centers to provide better access to care.

Context: Stable housing is associated with less stress, fewer emergency room visits and lower health care costs.

  • Housing affordability also affects health. More than 15% of U.S. adults this year reported delaying or skipping medical treatments to afford housing.
  • "We know that without access to safe and affordable housing, it's really hard to focus on health," said Catherine Anderson, senior vice president of health equity strategy at UnitedHealth.

How it works: UnitedHealth leverages federal tax credits for building low-income housing, and it invests a portion of its reserve funding in housing development, Anderson said.

  • Centene's new initiative provides loans to an affordable housing developer to help fund tasks before construction starts, such as site analysis, said chief health officer Alice Hm Chen.
  • Insurers said the housing developments are investments in the communities they serve and aren't just for their own customers.

Yes, but: Some experts are skeptical that housing aid is the best use of limited health care resources.

  • 19 states have received the federal government's permission to use Medicaid dollars to provide temporary housing support.
  • Building housing "could be a very good investment" for insurers, but it's too early to know if Medicaid will expand its housing coverage, said Leonardo Cuello, a Medicaid expert at Georgetown University.
  • "I have some concerns with Medicaid going too far down this route" of covering housing costs, in part because it could divert money needed to provide health care, he said.
  • "At the same time, undoubtedly, there's low-hanging fruit ... that's going to save money, and that's going to improve health care."

What they're saying: Some patient advocates argue that health insurers flush with profits have a responsibility to return money to consumers through new affordable housing.

  • "It's a natural nexus, when they have that much market share and power, to then invest that back into these key economic well-being indicators like housing," said Mona Shah, a senior director at Community Catalyst.

Our thought bubble: Health insurers already process most prescriptions, own pharmacy chains and employ scores of the country's doctors. Expanding into housing development is another example of their ever-growing footprints.

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