End the Medicaid Inmate Exclusion Policy
The Medicaid Inmate Exclusion Policy needs to be rescinded. This policy is a legislative error, one that increases recidivism and mortality, decreases health outcomes, is a violation of 5th constitutional right to due process, and is the financial equivalent of stacking piles of cash from counties’ budgets and giving them the torch.
County jails are the largest providers of behavioral health services in our country, and the people receiving services in this setting are ineligible for having their care covered by Medicaid. The costs related to this population are enormous and are borne nearly entirely by counties.
People in this setting are often in jail because they cannot afford bail. Nearly two-thirds of the people in county jails have not been convicted of a crime, and if they were able to go home on bail, they would retain their healthcare. Nearly 9000 kids can’t access their Children’s Health Insurance Program (CHIP) benefits. Veterans can’t access their VA benefits. Because these folks cannot afford to post bail, they — and the counties that house and feed them and cover their care — are punished.
As our national crisis of mental health and substance use disorders continues to rage under the shadow of Covid, we continue to poke around the edges. We continue to attempt to make slight changes to our programs, while ignoring the massive systemic misalignment that prevents our entire system from functioning. If we truly believe in addressing these crises, this is the type of reform that will be needed to affect change.
Despite the new-found energy behind criminal justice reform, despite being championed by the National Association of Counties and The National Association of Sheriffs, despite bipartisan support, this effort remains unfinished.
For those of us who care for people who use drugs — for those of us living in recovery, outside of an institution because of chance or privilege —it is a moral imperative to address this error in legislation. Now.