Reform expanding Medicaid to ex-prisoners, parolees

The Medicaid program is poised to expand to paroled felons and freed prisoners as a result of the Affordable Care Act, reported Stateline Health News.

The ACA extends Medicaid eligibility not only to the roughly 650,000 Americans released from prison custody every year, but also the approximately 5 million others who are on parole and probation, the article noted.

The change--which applies to the states participating in the Medicaid expansion under the ACA--could be a financial salve for hospitals, which are often stuck with the bill for treating uninsured patients.

Prisoners usually receive healthcare while they're incarcerated, although experts agree it tends to be uneven. However, this care usually ends upon their release from custody. Moreover, prisoners tend to have a much higher rate of chronic illnesses and serious healthcare events compared to the rest of the U.S. population.

The article pointed to a New England Journal of Medicine study of more than 30,300 Washington State residents recently freed from custody, which found the former prisoners had a much higher mortality rate than the general public because they could not access care on a consistent basis--two times higher during just the first two weeks after release.

The expansion of Medicaid coverage may not only jumpstart efforts to cut costs caring for this population via preventative care efforts, but also may give states a chance to shift the rapidly rising costs of caring for prisoners from the state to federal coffers, given that the federal government will pay 100 percent of Medicaid expansion between 2014 and 2016, and 90 percent after that.

According to the American Civil Liberties Union, about 246,000 U.S. prisoners are over the age of 50 and are therefore much more costly to care for, reported the Asbury Park-Press.

For example, a staff attorney with the Texas Civil Rights Project estimates Texas spends nearly $2 million a year on its 10 most medically expensive inmates, FierceHealthFinance previously reported.

For more:
- read the Stateline Health News article
- here's the NEJM study abstract (.pdf)
- read the Asbury Park-Press article