Health and Incarceration A Workshop Summary (2013) / Chapter Skim
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3 Access to Healthcare
3 Access to Healthcare
Pages 31-36
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From page 31... ...
MEDICAID ENROLLMENT Many prison and jail inmates are poor, lack insurance, and are in need of health services. By federal law, inmates already enrolled in Medicaid are precluded from receiving benefits while incarcerated.
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From page 32... ...
The authors make the following distinctions among inmates pending disposition: • Incarcerated individuals pending disposition are qualified to enroll in and receive services from health plans participating in state health insurance exchanges if they otherwise qualify for such coverage. • Individuals pending dispositions who satisfy bail requirements and are released into the community will be eligible to enroll in Medicaid and receive services so long as they meet the program requirements.
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From page 33... ...
Jails may also be in contact with persons who would otherwise avoid interacting with officials -- due, for example, to unpaid child support or immigration status. If jail staff made an effort to enroll inmates, this could make a substantial difference to realizing the potential of ACA to provide access to healthcare for uninsured individuals and open reimbursement streams for the localities providing care to inmates, arguably improving equity and health while lowering both health costs and recidivism.
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From page 34... ...
Scott Allen referred to this continuity as the "ideal." Josiah Rich (Department of Medicine and Epidemiology, Warren Alpert Medical School of Brown University, and the Center for Prisoner Health and Human Rights at the Miriam Hospital Immunology Center,) concurred from his own experience providing care, noting that "just seeing a familiar face" improves the experience for both doctor and patient, bolstering trust.
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From page 35... ...
Rosenberg observed, "By maintaining coverage for individuals within their health plans while they are within a correctional environment, the health plan's measurements will include the outcome measures." This could help improve the quality of care provided to inmates. Robert Greifinger suggested using the ACA as "leverage to encourage the participation of correctional health professionals in accountable care organizations, which will increase their contact with community healthcare folks." Allen affirmed the potential for improved quality of care when healthcare providers within correctional facilities are "answerable to the community standard." STATES AND HEALTH PLANS How much of the potential impact of the ACA is realized will depend in part on how states respond to the law and what initiatives they take to implement it, as well as on the strategies and practices of private health plans.
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From page 36... ...
Debates will no doubt address whether the current restriction against receiving Medicaid benefits while incarcerated is maintained, and may also be shaped by whether healthcare providers are employees of the state or of private health plans. Foreseeing an "interesting dynamic," Rosenberg suggested that "the implicit contractual right of the ACA may create some significant changes; we just don't know what they're going to look like yet."
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