Medicaid Expansion Helps Inmates Get Health Care

Dec 7, 2015

Someone who’s preparing to get out of prison has a lot to think about.  They have to find housing, a job, transportation.  Health care often falls to the wayside. But the state’s corrections department has begun to help inmates find insurance before they’re released.  Ohio’s decision to expand Medicaid plays a key role.

Each year, roughly 20,000 people are released from Ohio prisons. They haven’t left with much as far as health care is concerned.  They may have received drug treatment or mental health services referrals. If they’re taking medication, they get a short supply. Following through with treatment and getting drug refills…that’s been up to the inmate.

Stuart Hudson manages health care and fiscal operations for Ohio’s prisons.

“There was no linkage. They were being released, and if they didn’t have insurance there were no options for them other than try to go out and find it on their own," Hudson said. 

But then Governor John Kasich expanded Medicaid. With income eligibility raised, more inmates would qualify. And Ohio’s Medicaid chief John McCarthy wondered, “Had we in the past been working with them on getting people who qualify for Medicaid enrolled?”

The answer was no. But doing so would result in a win-win. 

“As they leave, they would be eligible to not only get the services they need but also have their prescriptions paid for," McCarthy said. 

The prisons and state Medicaid and Mental Health Departments teamed up to make it happen.

The pre-release Medicaid enrollment pilot program began at the women’s prison, in Marysville, 15 months ago.

About 90 days before their parole dates, inmates are introduced to the different programs offered in Ohio. A few days later, a Medicaid agent enrolls them over the phone.

“Medicaid is basing your eligibility on your incarceration status as a single adult," a woman explains to a group of inmates. The group of about 20, at the Ohio Reformatory for Women, intently listen to an explanation of how Medicaid works. Their instructor:  fellow inmate Sandra Griffin.

"Some of the services Medicaid provides are preventative care, mental health services, alcohol and drug addiction treatment," Griffin explained.

Some inmates serving life sentences, like Griffin, are trained to assist in the enrollment process. They answer basic questions, like this one from an inmate who wonders whether she’s eligible since she will be in a corrections transitional program before she’s released.

“What if you’ve got approved, but you haven’t got your bed day yet?" one inmate asked.

"If you haven’t got the bed, then the process still stands. You go through the process just in case, you can never can tell what will happen. And we want to make sure that the benefits and the opportunity gets extended to you," Griffin answered. 

For inmates who’ve been in prison for many years, adjusting to the outside is difficult. Inmate Amy McDonald, who’s been behind bars for 15 years, said the enrollment program helps.

“Had this program not been here I wouldn’t have known how to research it or choose it or anything. I would have just left out of here with nothing and had to go out there and figure this all out for myself," McDonald said. 

About a quarter of Ohio prisons now enroll inmates in Medicaid. More than 1,200 have registered so far. By the end of 2016, The prison system’s Stuart Hudson said every eligible inmate will have access.

“They have a continuity of care and access to health care once they are released from prison, which they have never had before," he said. 

Hudson said the program can help keep people from returning to prison. By connecting inmates to health care, he said it could keep the most vulnerable inmates – those with mental illness – from committing future crimes.

“That might resort to other means in order to procure medications or might decompensate and end up being involved with the criminal justice system again," Hudson said. "These services might help those types of individuals with their continuity of care and their access to community health services.” 

For Daneisha Harton, who lost her health insurance before she entered prison, enrolling now in Medicaid will fill that gap when she gets out, in April.

“It’s been hard when I’ll go to the hospital and I get these big bills in the mail, and it messes up my credit because I can’t afford to pay it. So it’s an opportunity I’m happy to have," Harton said.