The effects of mental illness and addiction on the corrections system is well known. Approximately 64% of inmates have a serious mental illness such as bipolar disorder, schizophrenia, or a brief psychotic disorder, 53% suffer with addictions, and 49% of this population has coexisting mental health and addiction disorder issues (see Federal Policy Impacts On County Jail Inmate Healthcare & Recidivism and Serious Mental Illness Prevalence in Jails and Prisons). And when these inmates are released, they seek more emergency care, are hospitalized more frequently, and have twelve times the mortality rate than the general public—leading to higher rates of recidivism (see Keeping On Top Of Innovations In Corrections Reentry Programs). While there are innovative programs on a state level, there is no national solution to this issue.
One issue in the mix is a growing trend to suspend instead of terminate — Medicaid eligibility for the inmate population. States are not allowed to use federal Medicaid funding for services provided to an adult inmate of a public institution (see Title XIX – Grants To States For Medical Assistance Programs). However, this does not apply to adolescents in juvenile justice facilities (see H.R.6 – SUPPORT For Patients & Communities Act). The rationale for suspending Medicaid eligibility is that it reduces administrative issues (and the time) associated with getting Medicaid-paid health care (and behavioral health) services when an inmate is released to the community. This option was introduced in the Patient Protection and Affordable Care Act in 2014, which allowed states to suspend and then provide immediate eligibility upon release.
Our team took a look at this issue in a recent analysis, published in State Policy On Medicaid Benefits For State Prison Inmates: A State-By-State Review. What we found is that 42 states (82%) suspend Medicaid enrollment for incarcerated individuals in jails, and 43 states (84%) suspend Medicaid enrollment for incarcerated individuals in prisons. This is a pronounced change from 2014 when only 12 states (23%) suspended rather than terminated inmate medicaid benefits for inmates in prisons or jails (see Which States Terminate Rather Than Suspend Inmate Medicaid Benefits?: An OPEN MINDS 2014 Market Intelligence Report).
One related policy initiative of note is the decision in New York to allow inmates to enroll in Medicaid up to 30 days before their release (see New York To Extend Medicaid Coverage To Incarcerated Individuals 30 Days Prior To Release). This allows health plans and provider organizations to have “in-reach” services that help to prepare the inmate for their return to the community. For a state-by-state analysis of Medicaid eligibility policies in corrections institutes check out our new report, State Policy On Medicaid Benefits For State Prison Inmates: A State-By-State Review. And for a look at current forensic initiatives, check out our recent coverage:
- California Prisons Roll Out Integrated Addiction Treatment Programs
- 15% Of Los Angeles Jail Residents Could Be Diverted Into Mental Health Treatment
- Two-Thirds Of Incarcerated Youth Are In Secure Facilities
- Virginia Juvenile Justice Overhaul Results In Fewer Incarcerated Children
- North Carolina Partners With Acivilate On ‘Pokket’ App For Prison Reentry Information Sharing
- Delaware Rebids Correctional Health Care Services For July 2020 Start Date
- California Passes Juvenile Justice Laws, Prepares To Move Juvenile Justice To Health & Human Services
- Benton County, Oregon Launches Criminal Justice System Improvements Project
- Oklahoma Implementing Criminal Justice Reform, Will Release Hundreds Of Prisoners
- Jail Populations Dropped 18% In Urban Areas, Climbed 27% In Rural Areas Since 2013