By Carli Friedman, CQL Director of Research
People with disabilities, especially those on Medicaid, are more likely to be housing insecure than nondisabled people. While the COVID-19 pandemic significantly increased housing insecurity in the United States, less is known about how people with cognitive disabilities were impacted, despite them being higher risk for COVID-19. For these reasons, the aim of this study was to examine the housing insecurity of Medicaid beneficiaries with cognitive disabilities during the COVID-19 pandemic. To do so, we analyzed pandemic data (April 2021 and May 2022) from 450,000 people (data were weighted to represent the US population).
Medicaid beneficiaries with cognitive disabilities were significantly more likely to be housing insecure than all other people with disabilities and nondisabled people. In fact, 26.3% of Medicaid beneficiaries with cognitive disabilities were behind on rent/mortgage payments, compared to 16.6% of all other people with disabilities and 9.1% of nondisabled people. In addition, 13.7% of Medicaid beneficiaries with cognitive disabilities believed it was very or somewhat likely that they would be evicted/foreclosed on in the next two months (figure below).
Likelihood of Eviction/Foreclosure of Those Behind on Payments
When asked how confident they were that they would be able to make their next housing payment on time, almost half (44.2%) of Medicaid beneficiaries with cognitive disabilities were not at all or slightly confident (figure below). In comparison, 15.4% of nondisabled people and 29.1% of all other people with disabilities were not at all or slightly confident.
Confidence in Next Payment on Time
In addition to being more housing insecure than all other people with disabilities and nondisabled people, there were differences in housing security among Medicaid beneficiaries with cognitive disabilities themselves. Medicaid beneficiaries with cognitive disabilities who were renters, also had visual disabilities, were Black, were ‘another’ race or multiracial, and had a household income of $25,000-$34,999 were more likely to be behind on rent/mortgage payments. There were also differences in eviction/foreclosure and next payment confidence based on: ownership status; disabilities; age; gender; race; education; marital status; household income; household employment loss; and household size (see full study for more information).
“Housing insecurity increases people with cognitive disabilities’ risk for institutionalization, becoming unhoused, and incarceration… People with cognitive disabilities may be further disadvantaged when also Medicaid beneficiaries due to Medicaid’s low income requirements, making them more likely to live in substandard housing and have a lack of affordable housing to choose from, resulting in financial incidents increasing their risk of becoming unhoused… Attention to Medicaid beneficiaries with cognitive disabilities’ experiences with housing insecurity during the pandemic is critical in order to develop programs and policies to facilitate housing security” (Friedman, 2022, pp. 5-6).
1 in 4: Housing Insecurity of People with Cognitive Disabilities on Medicaid