Reentry Starts on the Inside: Enrolling People in Jail and Prison in Medicaid

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Even though “reentry” typically refers to the time after a person is released from prison or jail, the reentry process really begins on the inside, prior to release. Some would say reentry planning should start the moment a person is sentenced, as it can take months or years for an incarcerated person to prepare for life back in the community. This means planning and preparing for the emotional and physical support systems required in reentry—safe and affordable housing, health care, employment, family support, and so on.

One recent change in our health care laws is bringing this principle to life—a ray of hope for people in jails preparing for reentry! In 2010, President Obama signed the Affordable Care Act (“Obamacare”) into law. Many of its provisions took effect just last month on January 1, 2014. One of the most powerful changes that Obamacare made to health coverage was the expansion of Medicaid eligibility to more of our nation’s poorest citizens. As Bloomberg reports, “Obamacare replaced a hodgepodge of state requirements that typically excluded childless adults from Medicaid. The 2010 law opened it to anyone making less than 138 percent of the federal poverty level, about $16,000 for an individual.” Many of the people in prison and jail fall within the expanded eligibility based on income, and 25 states—including California—have expanded their state Medicaid programs to include this newly eligible population. In particular, more and more counties in these 25 states are looking to jail-based programs to begin enrolling eligible people into Medicaid, so that a person can walk out of jail with health care coverage. Policies like this serve everyone: they help many currently and formerly incarcerated people access consistent health care and avoid emergency rooms when they get out; they help states save money on health care by taking advantage of federal money; and they help some of our nation’s poorest in jail and prison stay healthier and less likely to end up back in jail or prison once they get out. Reentry must begin on the inside.

Read more about Medicaid enrollment programs in jails here and here. Learn more about the expansion of California’s Medicaid (called Medi-Cal) program here and here. We hope to see more jails and prisons adopting procedures and policies for getting people eligible for Medicaid covered before they walk out the door!

— The R&R Team

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