(Portland, Oregon) — Oregon is set to become the first state in the country to cover climate change expenses for some low-income patients under its Medicaid program as the typically temperate Pacific Northwest experiences longer heat waves and more intense wildfires.
The new initiative, set to take effect in 2024, will cover payments for devices such as air conditioners and air filters for Medicaid members with health Circumstances living in an area where a severe weather emergency has been declared by the federal government or the governor’s office, according to the Oregon Health Authority.
Aims to help people “cope with the impact of intense heat“Bushfires and other disasters caused by climate change,” OHA Director Patrick Allen said.
The procedure is part of what the US Department of Health and Human Services’ Centers for Medicare and Medicaid Services has called “pioneering medical initiatives” in Oregon and Massachusetts.
The federal agency on Wednesday renewed medical waivers for both states. These exemptions will cover non-medical services such as food and housing assistance for people with clinical needs in an effort to address underlying social issues that can cause poor health.
Oregon will receive $1.1 billion in new federal funding for new Medicaid initiatives covering climate change, nutrition and housing, which health officials have described as “health-related social needs.” The state will be piloting the changes over the next five years.
“Health care does not happen in a vacuum – it is clear that we must look beyond the traditional, siled approach to truly addressing the needs of people, especially those facing complex challenges,” Oregon Governor Kate Brown said in a statement.
Massachusetts Governor Charlie Baker said his state “will continue to implement innovative reforms that deliver quality care, better health outcomes and equity.”
More from TIME
Oregon’s new Medicaid plan highlights two policies first in the state: climate change coverage, and a measure that would keep children consistently enrolled in Medicaid until age 6 without families having to re-enroll each year.
Officials in the Pacific Northwest are trying to adapt to the potential reality of extreme heat spells in the wake of the deadly “heat dome” weather phenomenon that led to record temperatures and deaths in the summer of 2021.
About 800 people died in Oregon, Washington and British Columbia during the heat wave as temperatures soared to an all-time high of 116 F (46.7 C) in Portland and smashed temperature records in cities and towns across the region. Many of those who died were older and lived alone.
In addition to covering payment for devices that maintain healthy temperatures and clean air indoors, Oregon’s new Medicaid plan will also cover generators in the event of a power outage.
“It depends on medical indications that you are particularly vulnerable to heat events, have energy-related medical devices, or are sensitive to smoke,” Allen said.
Oregon Medicaid members with health conditions will become eligible for such devices if they live in an area where a severe weather emergency has been declared.
Climate change can pose health risks, including heat-related illnesses during heat waves. Extreme weather events such as storms and floods can negatively affect both physical and mental health, and disrupt diets. The risks disproportionately affect low-income communities, the elderly, and those with underlying health conditions.
Medicaid is the federal state’s health care insurance program that helps pay for health care for low-income people of any age. Each state determines eligibility and the full scope of services covered. The federal government reimburses a percentage of state expenditures.
“There is a lot of discussion around climate change about making sure that while we address the health risks of climate change, we do so in a way that reduces inequality,” said Kristi Ibe, a professor at the Center for Global Health and the Environment at the University of California. University of Washington.
Ebee said Oregon’s Medicaid initiative “is an opportunity to reduce some of the inequalities for people who can’t afford it, for example, a generator to make sure life-saving equipment continues to run during heat waves.”
As for Medicaid food and housing assistance coverage, the states of Oregon and Massachusetts are expanding eligibility for such services.
Nutritional support can include customized meal plans based on health needs and Medicaid-funded prescriptions for fruits and vegetables. Housing services can include rent application assistance, transportation assistance, and eviction prevention.
Massachusetts will provide additional meal support for Medicaid members who are children or pregnant women with special clinical needs, according to the Centers for Medicare and Medicaid Services.
In Oregon, people facing life transitions, including those experiencing homelessness or at risk of homelessness, can be eligible for rental assistance for up to six months.
Claire Rush is a member of the Associated Press/Reporting for America’s Statehouse News Initiative. Report for America is a non-profit national service program that puts journalists in local newsrooms to report confidential issues. Follow her on Twitter Tweet embed.
More must-read stories from TIME