The VA’s Housing First Program
Introduction
The U.S. Department of Veterans Affairs (VA)’s Housing First program (HUD-VASH) is a program that provides permanent housing assistance to veterans. Veterans are able to choose an apartment freely; the voucher covers the rent after veterans contribute 30% of income. The voucher allocation process is slow and prioritizes those who are chronically homeless. The median wait time after referral is 3 months.
Ona alternative to HUD-VASH is the VA’s Grant & Per Diem Program (GPD), which provides transitional housing, among other smaller programs. Costantini (2025) uses an instrumental variables approach to quantify the effects of HUD-VASH on mortality compared to GPD as well as a no treatment counterfactual. The paper utilizes quasi-random variation in the length of waiting time for a voucher as an instrument for enrollment in HUD-VASH, and quasi-random variation in the availability of a transitional housing liaison at time of arrival as an instrument for GPD enrollment (as a housing liaison may be able to fast track a veteran for GPD options).
Pays for Itself
Net Cost
The net costs of HUD-VASH consist of the direct costs of housing and social worker visits and the savings due to reduced shelter stays and better health (measured as reduced inpatient stays).
The paper estimates the average cost of housing over 3 years is $13,380 and increased social worker costs of $9,667.
The paper estimates that the average cost of shelter stays is reduced by $246 and the cost of inpatient stays is lowered by $41,734 due to reduced use as a substitute for housing.
The net cost is then $13,380 + $9,667 – $246 – $41,734 = -$18,931.
Willingness to Pay
The paper does not provide an explicit value for the WTP, but argues that the willingness to pay should be positive because, in addition to the health and quality of life benefits, the vouchers pay for a veteran’s housing in lieu of their own payments.
MVPF Summary
The estimated MVPF of the program is infinite as the net cost is negative and the assumed willingness to pay is positive.
References
Constantini, Sydney (2025). “Housing First or Treatment First? Evidence from the VA’s Homelessness Programs.” Working Paper. https://drive.google.com/file/d/1C0gvQ3MltPwO6LLEqEKUjz6LdYG-A384/view
Policy Features
- Category
- Social Insurance
- Sub-Category
- Housing
- Beneficiary Type(s)
- Adults
- Average Age
- 50
- Country of Implementation
- United States
- Empirical Method
- IV
- Research Type
- Primary
- Peer Reviewed
- No
- MVPF Publication Link
- drive.google.com/file/d/1C0gvQ3MltPwO6LLEqEKUjz6LdYG-A384/view