How Health Care Reform Can Transform The Health Of Criminal Justice–Involved Individuals

Abstract

Provisions of the Affordable Care Act offer new opportunities to apply a public health and medical perspective to the complex relationship between involvement in the criminal justice system and the existence of fundamental health disparities. Incarceration can cause harm to individual and community health, but prisons and jails also hold enormous potential to play an active and beneficial role in the health care system and, ultimately, to improving health. Traditionally, incarcerated populations have been incorrectly viewed as isolated and self-contained communities with only peripheral importance to the public health at large. This misconception has resulted in missed opportunities to positively affect the health of both the individuals and the imprisoned community as a whole and potentially to mitigate risk behaviors that may contribute to incarceration. Both community and correctional health care professionals can capitalize on these opportunities by working together to advocate for the health of the criminal justice–involved population and their communities. We present a set of recommendations for the improvement of both correctional health care, such as improving systems of external oversight and quality management, and access to community-based care, including establishing strategies for postrelease care and medical record transfers.

Methadone continuation versus forced withdrawal on incarceration in a combined US prison and jail: a randomised, open-label trial

“…However, under the US Affordable Care Act, many more people released from prisons and jails could be eligible for health insurance, rendering costs less of an issue. 55,56 …”

Early primary care physician contact and health service utilisation in a large sample of recently released ex-prisoners in Australia: prospective cohort study

“…In effect, PCPs may be functioning as both physician and ‘case manager’ 5051 By reducing financial barriers for ex-prisoners, contemporary healthcare reforms, such as the Affordable Care Act in the USA, represent a pivotal opportunity for PCPs to foster correctional healthcare partnerships, promote timely engagement and provide targeted interventions in this previously underserviced group 56. In this context, our findings imply that increased cooperation and integration of prison and community primary care providers aimed at maximising PCP access soon after release from prison is a public health priority.…”

A Review of Opportunities to Improve the Health of People Involved in the Criminal Justice System in the United States

“…Issues such as Medicaid restrictions on coverage during incarceration and the need to align cross-systems performance metrics represent some of the challenges to be addressed in these processes. With focused policy efforts and shared goals of health and public safety across partners, over time, the ACA could facilitate reductions in the criminal justice population, while improving health outcomes in affected communities (91).…”