The Patient Protection and Affordable Care Act of 2010 (the ACA) aims to increase access to care, improve the quality of care, and lower total health c are costs. While the ACA can benefit all individuals and families, it has significant potential in expanding and improving services for those experiencing homelessness. Through the optional expansion of Medicaid and adoption of Medicaid waiver services and state plan amendments (SPAs), the ACA adds flexibility to the health care system to better meet the needs of low-income populations.

The mission of this paper is threefold. First, it provides detailed information about a selection of Medicaid and non-Medicaid provisions that states can implement to increase access to services and to expand the types of services available to people experiencing homelessness. This includes components established by the ACA as well as pre-existing opportunities. Second, it presents examples of how some states have taken advantage of these opportunities. And finally, it provides homeless service agencies with guidance on how best to advocate for change in their state’s health care system to better meet the needs of their clients.