Counties look to enroll current, former inmates in Medicaid

Up to millions of ex-convicts with incomes below the poverty line may have access to Medicaid coverage under the Affordable Care Act (ACA), Kaiser Health News reports.

Twenty-six states expanded Medicaid eligibility to single adults without children, including many currently incarcerated and released inmates. The latter often have uncertain income prospects, making them eligible for coverage. As many as 5 million former prisoners may be eligible nationwide.

Both current and former prisoners are often sicker than the general population, and tend to have significant mental health issues that also require treatment. A recent study by researchers at Yale University concluded that one out of 70 former inmates are hospitalized within a week of their release--a rate far higher than that of the general population.

Safety net hospitals usually had to bear the cost of care without reimbursement, but Medicaid will likely change that for a large proportion of both current and former inmates.

Under the ACA, Medicaid can pay for the care of current inmates who are hospitalized longer than 24 hours as well as anyone who has been released who meets the income criteria in states that have expanded their eligibility.

"That would shift the cost, essentially, from the county to the state or to the federal government," Richard Lucas, undersheriff for Alameda County in the Bay Area of California, told KHN.

States also have an economic incentive to provide Medicaid coverage to released convicts: studies suggest that former prisoners are less likely to reoffend if they have access to regular healthcare services, according to KHN.

"Healthcare can be a tool for social justice if it's delivered effectively and creatively, and that's why the Medicaid expansion is such a great opportunity for us," said Alex Briscoe, Alameda County's health director.

However, there are a variety of bureacratic obstacles to overcome to provide Medicaid coverage for all prisoners, as well as a general lethargy. Many states, such as North Carolina, have lost out on tens of millions of Medicaid dollars for eligible prisoners because officials never bothered to pursue payments.

To learn more:
- read the KHN article