Ensure access to non-emergency medical transportation

Approximately 3.6 million Americans do not obtain medical care because they lack transportation.[3][4] Inequitable access to transportation perpetuates disparities in access to health care and highlights the importance of transportation as a critical social determinant of health.[1][5] For adults without access to transportation, one in five forgo necessary health care services, including for mental health and substance use disorders (MH/SUD), which can interfere with consistent health care, create cumulative deficits in patient treatment, and negatively affect long-term health outcomes.[1][6][7][8] Individuals who are Black or Latino, have low family incomes, have public health insurance, or have a disability are more likely to skip care because of transportation barriers.[1]

Public transportation expansion improves access to health care, especially for people who live in urban areas; are Black, Hispanic/Latinx, or elderly; or have disabilities or low incomes.[1][2][5] NEMT is a Medicaid benefit that delivers people who lack transportation to necessary but non-emergent medical appointments, which commonly include MH/SUD treatment.[2][9][10] Improved access to NEMT for Medicaid beneficiaries results in cost savings for preventative services and treatment for chronic conditions.[2] While state Medicaid programs are required to provide NEMT benefits, administration and reimbursement varies considerably across states and some states have previously carved out the benefit through waivers.[1][2] Congress should require uniform access to NEMT for all eligible individuals covered by Medicaid.