The House Republican tax and budget bill, if passed into law, would make it more difficult for individuals experiencing homelessness to access health care and food assistance. As states attempt to tackle the rising rates of homelessness across the country, this bill would make the situation worse through historic cuts to both Medicaid and the Supplemental Nutrition Assistance Program (SNAP)—essential to the nation’s most vulnerable people—in order to give tax breaks to the wealthy. Added administrative burdens such as mandatory proof-of-residency checks and paperwork requirements would further hinder the ability of homeless or housing-insecure individuals to receive basic assistance.
Homelessness and chronic homelessness are on the rise
Proposed cuts to Medicaid and SNAP coincide with a national increase in homelessness and housing insecurity. In January 2024, an estimated 770,000 people experienced homelessness. From 2023 to 2024, there was an 18.1 percent increase in homelessness across the country—meaning 2024 had 100,000 more people experiencing homelessness compared with 2023. This coincides with a 6.6 percent increase in chronic homelessness. Sixty-five percent of individuals experiencing chronic homelessness were living in unsheltered locations in 2024.
Chronic homelessness is defined as a disabled individual experiencing continuous homelessness for at least a year or experiencing at least four episodes of homelessness in the past three years, with the number of days of those episodes equaling at least a year.
Medicaid and SNAP provide lifelines for individuals who experience homelessness. Anne Buchanen,* a mother from Centennial, Colorado, has a 40-year-old son with intellectual and developmental disabilities who has relied on Medicaid to avoid homelessness:
Through the Medicaid waiver, [Scott, Anne’s son] was placed in a group living situation that worked for a while, but was eventually kicked out … After that, he moved back in with me, but ended up homeless once more … before finally being placed back on a Medicaid waiver program. Now, he’s doing really well. His job, which he loves, also receives funding through Medicaid so that people with disabilities can be employed and be productive members of the community. Without Medicaid, he probably wouldn’t be alive today. Without this assistance, we likely wouldn’t be where we are now, and I doubt that there would be a happy ending to this story.
Homeless people may not be able to meet Medicaid residency verification requirements
In addition to forcing millions of Medicaid enrollees to comply with burdensome paperwork requirements, Subsection (a)(88)(A) of the bill would require all enrollees to prove where they live through regular address checks. Previously, proof of residency could include statements that one lived in a state or intended to live in a state. For example, North Carolina currently allows individuals to check a box on the application titled “NC Residency Declaration.”
Under the House Republican proposal, residency must be verified through one of three methods or other methods defined by the state and approved by the federal HHS secretary:
- U.S. Postal Service (USPS) postmarked mail or mail returned with a forwarding address
- Inclusion of name and address within the USPS National Change of Address database
- A managed care entity inpatient or ambulatory health plan can confirm a provided address
Unfortunately, individuals who experience homelessness may have significant difficulties regularly proving their residency due to frequent moves and the lack of a physical address at which to accept their mail. This makes it likely that homeless and housing-insecure individuals would lose access to health care coverage.
Congressional Republicans’ plan threatens food assistance for homeless individuals
Republicans on the House Agriculture Committee recently proposed their plan for the largest cuts to SNAP in history. Notably, the proposal would allow exemptions to paperwork requirements to sunset in 2030 for homeless individuals, along with other groups such as veterans and individuals ages 24 and younger who are connected to the foster care system. This would have devastating impacts for those who would struggle to provide the documentation necessary to maintain SNAP eligibility. Prior research has found that homeless individuals were disproportionately affected by burdensome paperwork requirements, often resulting in a loss of food assistance. Although many homeless individuals work, they face significant barriers in sustaining employment due to discrimination or material barriers such as a lack of address, identification, or transportation.
Homeless and housing-insecure people already face significant barriers in accessing food assistance and are more likely than housed people to be food insecure. It is estimated that 3.2 percent of all SNAP recipients, representing about 1 million people, experienced homelessness in fiscal year 2020. Changes to SNAP’s paperwork requirement waivers will worsen food insecurity among an already vulnerable population.
Under the Fiscal Responsibility Act of 2023, homeless individuals received exemptions from burdensome paperwork requirements. This act instituted an expansive definition of homelessness, including individuals who are actively homeless as well as imminently homeless, or housing insecure, individuals. The U.S. Department of Agriculture estimates that paperwork requirement exemptions for homeless individuals would help more than 300,000 individuals access SNAP benefits. Sunsetting the exemption and reverting to the previous policy would push more people into financial instability and homelessness.
The U.S. Department of Agriculture estimates that paperwork requirement exemptions for homeless individuals would help more than 300,000 individuals access SNAP benefits.
U.S. Department of Agriculture in Federal Register 89 (84) (2024).
House Republicans should focus on funding services to reduce homelessness
Medicaid and SNAP are key tools in reducing economic instability and thus helping people avoid homelessness. A study analyzing 2008–2013 data in California showed that for every 1,000 new Medicaid enrollees, there were 22 fewer evictions per year. Some states also provide housing assistance as an optional Medicaid benefit. Research on SNAP found that a 21 percent increase of the maximum benefit through the Thrifty Food Plan in 2021 helped 2.9 million people stay out of poverty that year. Earlier research considered residents in a Cleveland, shelter and found a positive correlation between receiving SNAP benefits and being less likely to need to use the shelter in the future.
Housing-first initiatives have also proved to be effective at reducing homelessness. This policy approach provides housing without the precondition of sobriety or treatment compliance. Many programs also provide optional services to help support individuals in working toward their personal goals. Housing-first programs have helped veterans become one of the only groups to see a reduction in homelessness in the past few years. The U.S. Department of Veterans Affairs, alongside the U.S. Department of Housing and Urban Development and the U.S. Department of Labor, ran the Veterans Homelessness Prevention Demonstration program from 2011 to 2014 and found that providing housing assistance to homeless veterans or veterans at risk of homelessness increased housing security, employment rates, and wages over that time period.
Research shows that reducing homelessness can reduce Medicaid costs. In New York, researchers found that a program that provided individuals experiencing chronic homelessness with supportive housing units and services helped reduce Medicaid costs by $9,526 per person from 2007 to 2010. For example, a 2013 Oregon study reported a 55 percent reduction in Medicaid costs one year after individuals experiencing homelessness received permanent supportive housing.
Conclusion
House Republicans’ reckless proposed changes to Medicaid and SNAP eligibility would make it increasingly difficult for homeless and housing-insecure individuals to access basic needs such as food and health care. These individuals already face unique barriers in accessing social support programs, and these changes would only serve to make it harder for them to climb out of poverty. Congress should instead work to improve access to these vital programs.
* Anne Buchanen provided this quote to the Center for American Progress via email on May 19, 2025.
The authors would like to thank Rachael Eisenberg, Andrea Ducas, Kyle Ross, and Lily Roberts for their reviews; Aurelia Glass for fact-checking; and CAP’s Editorial and Legal teams for their guidance.