Medicaid’s Role in Safeguarding Health Equity While Fostering Reduction of Harmful Greenhouse Gas Emissions

Since its inception, Medicaid has played a leading role in promoting health equity by providing health care to people experiencing structural inequities, such as people of color, children, older adults, and people with low incomes. Carbon dioxide and other greenhouse gases contribute to climate change, which disproportionately impacts these same groups of people that Medicaid was designed to serve. Currently, some state Medicaid agencies are beginning to explore the role they might play in addressing the fact that the health system generates roughly 9% of all carbon emissions in the United States.

State Medicaid agencies have an opportunity to encourage health care providers to implement and measure actions, such as sustainable procurement practices, to reduce harmful GHG emissions while safeguarding health equity for the people they serve. However, not all providers have adequate capacity to do so, and emissions reduction requirements without sufficient financial support and technical assistance might unwittingly exacerbate inequities. To proactively address this risk and support providers, state Medicaid agencies can gather input from other state agencies, providers, and community groups to identify and address equity concerns and incorporate this input into measures and policies they design. They can then provide education and technical assistance to build providers’ capacity to implement and measure decarbonization efforts. This brief explores how Medicaid can continue to protect and promote health equity while driving new efforts to reduce GHG emissions from the health system.