CSG Justice Center Releases Report on Corrections and Health Care Spending

The CSG Justice Center released a new policy brief in partnership with the Legal Action Center that outlines opportunities for states and localities to improve public health and safety outcomes and reduce spending on corrections and health care services by maximizing the appropriate use of Medicaid coverage for people involved with the criminal justice system. 

People in prisons and jails often have complex and costly health care needs, and states and local governments currently pay almost the entirety of these individuals’ health care costs. In addition, as many as 70 to 90 percent of the some 10 million people released from prison or jail each year are uninsured. The majority of these individuals have little or no access to health care services and experience gaps in continuity of care, which are associated with poor health outcomes and increased recidivism, particularly among those with mental illnesses and substance use disorders. 

The failure to link this population to health coverage and services upon release from incarceration is especially costly to state and local governments, which finance a significant portion of spending on care for the uninsured and the entirety of the burden of correctional costs for individuals who recidivate and return to the criminal justice system. The appropriate application of federal Medicaid resources for individuals involved with the criminal justice system presents an opportunity for savings by states and localities and helps minimize health and public safety concerns associated with reentry following incarceration. This policy brief identifies policy and programmatic options that allow states to take advantage of these opportunities by

  • Maximizing the enrollment of Medicaid-eligible individuals by screening for eligibility and facilitating enrollment at all points in the criminal justice system
  • Suspending rather than terminating Medicaid enrollment for inmates of correctional institutions
  • Making effective use of available federal Medicaid dollars to finance certain inpatient medical care provided to Medicaid-eligible inmates
  • Working with state health and insurance officials to ensure that Medicaid benefits are adequate to meet the needs of people involved with the criminal justice system, particularly with regard to mental health and substance use treatment 

While each of these opportunities existed prior to the passage of the Patient Protection and Affordable Care Act (ACA), the expansion of eligibility for Medicaid under the law will make these opportunities even more significant for states that choose to expand Medicaid eligibility. Still, the opportunities are significant in all states, regardless of whether they have chosen to expand Medicaid; for instance, North Carolina has saved an estimated $10 million by billing Medicaid for eligible inpatient medical care for inmates in fiscal year 2012. 
To learn more and download Medicaid and Financing Health Care for Individuals Involved with the Criminal Justice System, click here.

This CSG Justice Center policy brief was produced in partnership with the Legal Action Center, whose staff authored the content. Support for the production of this policy brief was provided by the U.S. Department of Justice’s Bureau of Justice Assistance.