Summary of State Actions: Medicaid and Justice-Involved Populations

Persons who return to the community after experiencing incarceration face many challenges. Addressing basic needs like food, clothing, and shelter is likely their priority, as many do not have a home to which they can return upon discharge. Even for those who receive family support, it is challenging to navigate the process of obtaining and maintaining the services they need to thrive in the community. To end this inequity, we must provide healthcare coverage, such as Medicaid or Medicare, to people leaving prisons to ensure they have access to life-saving healthcare and medications. Still, few go with healthcare coverage on the day of release, and those who do tend to be persons who have had very short incarcerations, measured in days, not months or years. Depending upon the length of imprisonment, most individuals' benefits like healthcare coverage and food assistance are suspended or terminated upon incarceration. Upon release from incarceration, returning citizens must work to have benefits reinstated with discharge paperwork. This process alone is a barrier.

Recognizing this challenge, various states are requesting that the Centers for Medicare & Medicaid Services (CMS) allow the usage of 1115 research and demonstration waivers so they can facilitate the eligibility of Medicaid for justice-involved persons. If implemented effectively and by engaging people with lived experience (PLE) and cross-sector partners (criminal justice partners, primary care providers, pharmacy, housing options, etc.), these strategies can support continuity of care, improve health equity, decrease costs and prevent recidivism.

The report below highlights the actions states and other entities have taken or are requesting to take to allow benefit activation before people return to their communities after release from long-term incarceration

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