A large proportion of renters vulnerable in the case of a healthcare shock, do not hold a medical card

Despite concern among the public and policymakers about housing and healthcare in Ireland, limited information exists on the relationship between these two critical issues. New research by the Economic and Social Research Institute (ESRI), presented at the annual Budget Perspectives conference on June 15th, highlights significant variations in health outcomes and medical card coverage across supported renter, private renter, and homeowner tenure groups in Ireland. The variations we report should not be interpreted as showing causation, but it is important to identify the patterns for a variety of reasons including healthcare delivery.

Supported renters

Findings show that individuals in the supported rental sector experience the poorest health outcomes. Half of all older adults (aged 65+) in supported rental housing report poor self-reported health, in contrast to one-third of older homeowners. A decline in medical card coverage among supported renters is found, with only 74% holding a medical card in 2021 compared to 87% in 2015. Less than half of employed supported renters possess a medical card, despite facing a high risk of poverty and having incomes that qualify them for public housing assistance.

Private renters

Private renters are found to have poorer health outcomes compared to homeowners across all age groups, in combination with lower rates of medical card coverage. A quarter of private renters with a chronic illness are at risk of poverty, yet the majority lack a medical card. Additionally, over a quarter of older private renters with a chronic illness do not hold a medical card. These findings, combined with previous research demonstrating the financial benefits of possessing a medical card in reducing the burden of healthcare, highlight the significant financial risk faced by vulnerable private renters in the event of a health shock.

Brendan Walsh, an author of the report and Senior Research Officer at the ESRI said: “Despite both housing and healthcare supports being integral parts of the social welfare system, a disconnect exists between them. Greater synchronisation between housing and health, and policies such as indexing income thresholds for medical cards, would see many vulnerable groups benefitting the most, including employed supported renters and lower-income private renters.”

Harry Humes, an author of the report and Research Assistant at the ESRI said: “The lack of medical card coverage for individuals with chronic conditions and housing insecurity exacerbates their risk of poverty. The combined financial burden of increasing rents and healthcare costs could pose significant vulnerability. A medical card eligibility system that better incorporates healthcare needs rather than solely income could provide greater protection for these vulnerable groups.”