In reducing the massive population of people who are in prison, one important tactic is to provide support for people who are released. Without programs to help them reintegrate successfully into society, many end up back in jail–a national study in 2005 showed that 75% of prisoners are re-arrested within five years of their release. One neglected aspect of support for former convicts is in the area of health care.
Federal law says that anyone serving time isn’t eligible for Medicaid, and as you can imagine, enrolling isn’t the first priority of somebody who has just gotten out of jail. This leads to all kinds of trouble.
For instance, many released inmates suffer from mental problems or drug problems. Without Medicaid, a newly-released patient won’t have access to the prescription drugs they had when in the prison system. This can lead either to relapses, illness, or the ex-prisoner committing offenses in order to get the medication they need. More seriously, the mortality rate of newly-released inmates is 13 times higher than that of the general population, in the first two weeks after release. This is mostly down to drug overdoses.
To combat these problems, many institutions are introducing programs which help people enroll in Medicaid as part of the Affordable Care Act upon their release and also helping them get appointments with doctors who will accept their medical cover. A new report from Johns Hopkins University looks at the effect of these programs and shows that providing medical care to people who have just gotten out of jail reduces the likelihood of them ending right back in prison.
The study counted 112,000 people who have been helped in the past year by these programs, but points out that the numbers may be higher, as not all figures are reported. So far, only 30 states, plus the District of Colombia, have established enrollment programs, but hopefully the clear benefits will speed an expansion. Even right-wing skeptics may be swayed by the fact that these programs save money–if an ex-inmate ends up back up inside, they’d cost a whole lot more to take care of and would enjoy free medical care anyway.
The Cook County Jail in Chicago begins the enrollment process when the inmates first arrive, lining things up so they can be enrolled in Medicaid upon release. This has the advantage, says Johns Hopkins, of letting the prisoners use their prison IDs to sign up. Lack of correct ID, it says, can be a big barrier to enrollment.
Programs like this, along with federal policy changes that would suspend instead of canceling Medicaid eligibility during incarceration, should be rolled out nationally, say the report’s authors. But insurance is just the beginning, says study co-author Sachini N. Bandara. “You need to facilitate access to health care providers. This is a population that has been largely ignored as they have fallen through the cracks in the system. These new Medicaid eligibility requirements are a huge opportunity to make a real difference in the lives of poor men.”