As a presidential candidate, Joe Biden promised to expand the use of community health workers to prevent and treat chronic conditions in economically disadvantaged communities.

During his first year in office, several states have worked to increase the number of community health workers under Medicaid, the federal-state program that pays for health care for lower-income Americans.

Community health workers operate on the front lines, connecting individuals and families to health care resources in their local community. They include care coordinators, community health educators, outreach and enrollment agents, patient navigators and peer educators. 

Community health workers often work to enroll lower-income Americans into Medicaid, a program that is handled somewhat differently in every state. Every year, the Kaiser Family Foundation surveys Medicaid budgets in all 50 states to track trends.

In the most recent survey, released in October 2021, Kaiser found that a number of states are working to expand the number and reach of community health workers. 

Five states are adding community health workers as a Medicaid-covered service for fiscal year 2022: California, Illinois, Louisiana, Nevada and Wisconsin. California and Illinois are going further by establishing community health workers as a specific provider category under Medicaid, as are Arizona and the District of Columbia.

Meanwhile, Colorado and Oregon are incorporating community health workers into their redesign of case management coordination under Medicaid. Oregon also passed state legislation to recognize tribal traditional health workers as a type of community health worker.

It remains to be seen whether the total number of community health workers will rise by 150,000, as Biden promised. But states are leveraging the federally funded Medicaid program to expand the use and reach of community health workers. We rate this promise In the Works.