Why People in Prison and Jail Should Be Enrolled in Medicaid
Date:  12-16-2015

Reasons include promoting easier access to health care by returning citizens and states receiving more federal funds
Via Pew Charitable Trusts December 8, 2015

How Medicaid Enrollment of Inmates Facilitates Health Coverage After Release

MEDIA CONTACT: Jeremy Ratner. Director, Communications

202.540.6507

jratner@pewtrusts.org

Overview

As more states and localities have begun to re-evaluate and reform their criminal justice systems in recent years, policymakers have devoted increased attention to the health care provided to individuals transitioning in and out of prisons and jails. Health care and corrections have each emerged as fiscal pressure points, and so too has the intersection of these two spheres: health care for inmates. States alone spent $7.7 billion on health care for prison inmates in fiscal year 2011.1 Moreover, because of the extensive and, in some cases, communicable health conditions of many inmates, officials recognize that facilitating seamless access to health care upon re-entry into society improves the individuals’ prospects for successful reintegration and benefits the public’s health and safety. Offenders frequently enter jail or prison with a substance use disorder and/or a mental illness2 and have high rates of chronic medical conditions (such as hypertension and diabetes) and infectious diseases (such as HIV and hepatitis C).3 Care continuity can be especially critical with the treatment of behavioral health conditions.4

Health insurance is a key ingredient of access to quality care for all Americans, including individuals involved with the justice system. But many offenders—nearly 80 percent, according to some estimates—have historically returned to their communities uninsured because they were initially without access to employer-sponsored insurance, unable to afford insurance in the individual market, or did not qualify for safety net health programs such as Medicaid.5 The Affordable Care Act (ACA) created an opportunity for states to change this situation by providing additional federal money to states that expand their eligibility criteria for Medicaid coverage under the terms set forth in the law. States may elect not to participate in the optional ACA expansion and instead adopt a partial eligibility expansion, but they will not receive enhanced federal support. Several jurisdictions have found that providing coverage contributes to improved care continuity among returning inmates, especially when paired with additional actions such as connecting individuals with community health providers and case management, thereby preserving the benefits of care delivered during a jail or prison stay, and reducing reliance on expensive, uncoordinated emergency department care.

Read the brief here.