By Atyya Chaudhry, MPP
Policy Analyst, Health Reform Impementation; AMCHP
The incarceration rate in the Unites States is one of the highest in the world. The majority of incarcerated individuals are adult males who are African-American or Hispanic, but the incarceration rate of female adults is on the rise. According to the Sentencing Project, between 1980 and 2014 the number of incarcerated women increased by 700 percent. Additionally, more than 60 percent of women in state prisons have a child under age 18. Justice-involved individuals have disproportionately higher rates of chronic conditions, infectious diseases, mental health disorders and substance use disorders. Access to health care is especially important for justice-involved individuals who are transitioning back into their communities – the same communities where women, children and families reside. According to an issue brief by the U.S. Department of Health and Human Services (HHS), poor health and poor access to care after release are associated with higher rates of recidivism. Conversely, improved access to health care is associated with improved employment, housing and family support. Access to health care for justice-involved individuals re-entering the community can have a positive impact on both the individual and community, through improved health and well-being, lower recidivism and improved community safety.
The Medicaid program is critical for providing health care to the justice-involved population. In early May, HHS released guidance for state health officials on how to improve access to health care for justice-involved individuals. The letter provides guidance on how states can improve access to health care through Medicaid for individuals transitioning back into their communities, as well as clarification and guidance on many aspects of Medicaid coverage for justice-involved populations. This includes the distinction between inmates in public institutions versus those in home confinement or on parole or probation, as well as eligibility for Medicaid while incarcerated and Medicaid coverage in a different state. The letter to state health officials (SHO No. 16-007) also discusses dealing with Medicaid suspension upon incarceration and shares strategies to promote continuity of care in light of suspension of coverage. This map by Families USA provides a glimpse of Medicaid suspension or termination policies in the U.S.