Leveraging The Affordable Care Act To Enroll Justice-Involved Populations In Medicaid: State And Local Efforts

Abstract

The Affordable Care Act provides an unprecedented opportunity to enroll criminal justice–involved populations in health insurance, particularly Medicaid. As a result, many state and county corrections departments have launched programs that incorporate Medicaid enrollment in discharge planning. Our study characterizes the national landscape of programs enrolling criminal justice–involved populations in Medicaid as of January 2015. We provide an overview of sixty-four programs operating in jails, prisons, or community probation and parole systems that enroll individuals during detention, incarceration, and the release process. We describe the variation among the programs in terms of settings, personnel, timing of eligibility screening, and target populations. Seventy-seven percent of the programs are located in jails, and 56 percent use personnel from public health or social service agencies. We describe four practices that have facilitated the Medicaid enrollment process: suspending instead of terminating Medicaid benefits upon incarceration, presuming that an individual is eligible for Medicaid before the process is completed, allowing enrollment during incarceration, and accepting alternative forms of identification for enrollment. The criminal justice system is a complex one that requires a variety of approaches to enroll individuals in Medicaid. Future research should examine how these approaches influence health and criminal justice outcomes.

Health Insurance Trends and Access to Behavioral Healthcare Among Justice-Involved Individuals—United States, 2008–2014

“…1,24 Several states have also developed unique insurance enrollment processes for justice-involved individuals that may not have been optimized in the first year of Medicaid expansion. 25 For instance, some jails and prisons began allowing Medicaid enrollment during incarceration, accepting alternative forms of identification, and developing electronic enrollment systems in 2014. 26 Follow-up study is needed to assess whether coverage has increased among justice-involved individuals due to these enrollment efforts or increasing familiarity with eligibility over time, and as more states adopt Medicaid expansion.…”

A Call to Action: A Blueprint for Academic Health Sciences in the Era of Mass Incarceration

“…Research is needed to explore these issues in different jurisdictions due to state-level variations in embracing and implementing the ACA. 33,34…”

Navigating Social Networks, Resources, and Neighborhoods: Facilitators of Sexual and Reproductive Health Care Use among Women Released From Jail

“…However, in the current political climate, all of these health care access resources are at risk. Enrolling women in social services pre-release (Bandara et al, 2015) and community-based advocacy and patient-navigation programs designed specifically for underresourced urban communities would also address the unique needs of women as they leave jail and could effectively address mitigation of SRH risk at the community level (Draine et al, 2011; Koester et al, 2014). Also useful would be home visiting models for care that are comprehensive in their approach in that they address neighborhood safety, poverty, mental health, and broader social context, such as the Nurse-Family Partnership model (Olds, 2006).…”