Health experts welcome HHS’s move to provide health insurance to some inmates before their release

The U.S. Department of Health and Human Services has authorized Illinois, Kentucky, Oregon, Utah and Vermont to offer health insurance to prisoners before their release through Medicaid/Children’s Health Insurance Program (CHIP), the agency announced last week. Several health care leaders support the agency’s move.

Under the Medicaid Section 1115 Reentry Demonstration Opportunity, states can cover certain Medicaid/CHIP services up to 90 days before a person is released from prison or a juvenile detention center. This includes services for substance use disorders. States can also refer released prisoners to community-based Medicaid and CHIP providers. These five states join California, Massachusetts, Montana and Washington in offering pre-release coverage.

Currently, patients lose their Medicaid benefits while incarcerated, and it typically takes about three to six weeks for coverage to be reinstated after applying, according to Stephanie Strong, CEO of substance use disorder provider Boulder Care, which often supports individuals who are currently or formerly incarcerated. In addition, people with opioid use disorder “typically receive little or no medical treatment for their condition while incarcerated,” she said. And the problems continue when they return to society.

“After discharge, people are overwhelmed with finding housing and jobs, reconnecting with the most important people in their lives, and staying healthy,” Strong said in an email. “Finding treatment and figuring out how to pay for it is a serious burden: and studies show that the risk of overdose increases more than 100-fold during this fragile post-discharge period. When a doctor is willing to treat a patient without insurance and write them a prescription for (medication-assisted treatment), the pharmacy often does not provide affordable medications if they are not covered by insurance.

“A seemingly small ‘gap’ in care can quickly become a major obstacle, especially when six weeks without medication can have devastating consequences for a life-threatening condition like opioid addiction,” she added.

Meghann Perry, founder of recovery support company The Meghann Perry Group, called the HHS action a “logical step.” Perry has experience with substance abuse and incarceration.

“Providing ongoing, high-quality mental health and substance use services to community members who have been in trouble with the law is a critical factor in reducing recidivism and improving the overall well-being of our communities,” she told MedCity News. “It is a key element in reducing overdose deaths and, at least financially, makes perfect sense. If I had not benefited from ongoing services for my substance use and mental health issues after I left the criminal justice system, I am not sure I would have survived re-entry. We must ensure that this care is expanded to every state and territory in the United States – immediately.”

Hans Morefield, CEO of CHESS Health, also welcomed the HHS move. The digital health company provides support for substance use disorders and offers a solution for community organizations working with inmates, as well as a solution for those being released from prison.

“This decision should enable those affected to make a smoother transition from prison treatment to community-based care, improve chances of reintegration, prevent overdoses and reduce recidivism,” he said.

Inmates often suffer from higher rates of substance use disorders, chronic physical illnesses, and poor medical care. About 85% of prison inmates have an active substance use disorder or have been incarcerated for a drug offense, according to the National Institute on Drug Abuse.

“Expanding access to life-saving treatment and recovery support for incarcerated individuals is a critical part of our bipartisan effort to defeat the overdose epidemic and save lives. … With this important action today, the Biden-Harris administration is offering these states a groundbreaking opportunity to improve access to health care, including substance use disorder treatment, in prisons and jails, and to provide historically underserved and marginalized individuals with the tools and resources they need for successful reintegration,” said Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy (ONDCP), in a statement.

According to the announcement, CMS is working with several other states on demonstration applications for reinstatement into the Medicaid contract under Section 1115.

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