Committee discusses bill to extend Medicaid coverage to inmates prior to release

The House Energy & Commerce Health Subcommittee discussed the Medicaid Reentry Act of 2021 during a hearing on substance misuse and the opioid epidemic on Wednesday. The bill, which is sponsored by Congressman Paul Tonko, would allow states to make Medicaid coverage available for incarcerated individuals up to 30 days prior to release.

Current law doesn’t allow incarcerated individuals to enroll in Medicaid until after being released.

 

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In a letter to Tonko and other members of Congress, the National Alliance on Mental Illness (NAMI) reasoned that allowing coverage prior to release would help connect individuals to care and would reduce recidivism.

“Most of these individuals lack health insurance and will face barriers navigating and gaining access to public health care programs. Practically, when individuals reenter their community, establishing or re-establishing health care often takes the backburner as they deal with more pressing needs…research has shown that when people are enrolled in health care upon release, they are more likely to engage in community-based services and less likely to recidivate.”

NAMI says that about 80% of individuals released from prison in the U.S. have a substance use disorder, chronic medical, or psychiatric issue.

“Providing a warm handoff to community-based mental health and substance use disorder services, medications, and supports will more effectively address mental health care needs immediately before and during reentry and help save lives.”

Provisional data from the Centers for Disease Control and Prevention (CDC) indicates that overdose deaths in the United States increased 26.8% between September 2019 and September 2020. During that time, over 87,000 overdose deaths were reported in the country.

The risk of overdose is particularly high for individuals recently released from incarceration. One study that evaluated former Washington State prison inmates found that during the first two weeks after release, former inmates were 129 times more likely to die from a drug overdose than other state residents. The study identified drug overdose as the leading cause of death for these inmates.

During the committee hearing, Tonko said his bill is considered one of the most effective policies to reduce opioid overdoses.

“The Medicaid Reentry Act would empower states to restore Medicaid eligibility for incarcerated individuals up to 30 days before their release to ensure those transitioning will have immediate access to critical services including mental health support, addiction treatment, and COVID testing.

Granting states the ability to jump-start Medicaid coverage for these individuals will mean they are not only able to receive life-saving treatment for mental health, substance use disorders, and other conditions, it will also help them stay out of our already overburdened hospitals and on the path to recovery and rebuilding their lives.”

The Medicaid Reentry Act would also require the Medicaid and CHIP Payment and Access Commission to submit a report to Congress that details standards for health and safety for inmates in correctional facilities, evaluates medical and behavioral health services available to inmates, and assesses Medicare and Medicaid conditions of participation for hospitals, psychiatric facilities, and other relevant provider types.

Regina LaBelle, Acting Director of the White House Office of National Drug Control Policy, also offered her take on the policy during the subcommittee hearing.

“We need to make sure that people, regardless of their circumstances, have access to evidence-based treatment. And providing incarcerated populations access to treatment before they leave is one way to do that. We also need to make sure that we follow up, that there are reentry tools available to help people with their recovery…this is a high-risk population that we need to get services to.”