La administración Biden ha dado un paso importante hacia una transformación de Medicaid, el programa federal de seguro médico para personas con bajos ingresos. En 2022, el presidente Joe Biden animó a los estados a ampliar las prestaciones cubiertas por Medicaid para incluir servicios sociales que tradicionalmente no estaban cubiertos por el seguro médico. Esta decisión se basa en la creencia de que la atención médica es solo una parte del bienestar general y que problemas sociales como la carencia o la inseguridad alimentaria pueden causar o empeorar problemas físicos o mentales.
Impacto del Experimento en Carolina del Norte
El experimento pionero en Carolina del Norte, autorizado durante el primer gobierno de Donald Trump, ha demostrado que canalizar fondos de atención médica hacia servicios sociales puede tener un impacto positivo en la salud y reducir costosos procedimientos médicos y atención de emergencia. Los beneficiarios de Medicaid han podido acceder a beneficios como:
- Dinero para pagar el depósito y el primer mes de un alquiler.
- Transporte a citas médicas.
- Rampas para sillas de ruedas.
- Recetas para frutas y verduras frescas.
Apoyo Bipartidista y Expansión de Beneficios
La disponibilidad de estos servicios ha crecido tanto entre republicanos como demócratas después del apoyo presidencial. Desde entonces, otros 24 estados han seguido ampliando las prestaciones cubiertas por Medicaid. Este cambio está transformando un sistema centrado en la atención médica en uno que prioriza la prevención.
Importancia de Abordar Problemas Fundamentales
Anthony Iton, experto en determinantes sociales de salud, destaca que “simplemente conducirá a más muertes” si no se abordan estos problemas fundamentales. La evidencia sugiere que aproximadamente el 85% del bienestar general está influenciado por factores externos, como:
- Acceso a alimentos sanos.
- Lugar donde dormir.
La atención brindada solo representa aproximadamente el 15% del bienestar general.
Innovaciones en el Uso de Fondos de Medicaid
Los estados están encontrando formas innovadoras para utilizar los fondos disponibles bajo Medicaid. Algunos ejemplos incluyen:
- California: Ofrece $1 al día por cada día completo de asistencia escolarizada.
- Florida: Proporciona hasta $500 mensuales adicionales si sus beneficiarios tienen empleo.
- Maine: Ofrece hasta $1,000 mensuales adicionales si sus beneficiarios tienen empleo con beneficios completamente pagados.
Conclusión
A medida que los estados continúan explorando nuevas formas de utilizar los fondos disponibles bajo Medicaid, es probable que veamos una mayor transformación del sistema hacia uno más centrado en la prevención y la promoción del bienestar general.

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