Ending "Housing First" program is putting 100,000 back on the street
by University
of Colorado Anschutz
edited by Gaby Clark, reviewed by Robert Egan
Researchers at the University of Colorado Anschutz estimate
that ending support for federally funded permanent supportive housing (PSH) and
rapid rehousing (RRH) programs would result in 44,590 additional people
experiencing homelessness within a single year, a roughly 5% increase from 2024
levels.
Housing First programs have been a cornerstone of national
homelessness policy since federal pilots began in 2003, demonstrating improved
housing stability and reduced dependence on health care systems. A July 2025
Executive Order sought to eliminate discretionary federal spending on these
programs, prompting researchers to quantify the immediate impact of that
decision.
"Our analysis shows that the loss of federal support for Housing First programs would have swift and significant consequences for communities across the country," said Josh Barocas, MD, associate professor at CU Anschutz and study corresponding author.
"These programs are often the final safety net for
people with complex medical and social needs. Removing that support would push
tens of thousands in both rural and urban communities back into homelessness
almost overnight."
Using the best available data, investigators modeled
one-year changes in homelessness under several policy scenarios, including full elimination of federal
support, funding removal for PSH only, and removal for RRH only.
Key findings include:
- Complete
elimination of Housing First funding = 44,590 additional PEH
- End of
PSH funding but continued RRH support = 13,210 additional PEH
- End of
RRH funding but continued PSH support = 38,890 additional PEH
The model incorporated program exits, relapse to
homelessness, loss of replacement housing units, increases in entries into
homelessness due to diminished support and annual mortality rates among PEH.
"These short-term projections highlight only a fraction
of the broader harms communities could face and so are likely an
underestimate," notes Kirk Fetters, MD, the study's first author and
infectious disease clinical fellow at CU Anschutz School of Medicine.
"Without effective
housing interventions, local systems—from hospitals to shelters—will
experience mounting pressure."
The study did not estimate long-term effects but underscores
the immediate implications policymakers should consider when evaluating changes
to Housing First funding.
More information
JAMA Health Forum (2025). DOI:
10.1001/jamahealthforum.2025.5747
Journal information: JAMA Health Forum
