Last year President Obama was hailed by many in the healthcare reform movement for signing into law the Patient Protection and Affordable Care Act (PPACA), and the Health Care Education Reconciliation Act. Both Acts are referred to as PPACA. The PPACA broadens the scope of eligibility for Medicaid, a move that will allow those with a criminal history to obtain necessary medical services more easily and effectively.
In anticipation of the new law taking effect, the has issued a FAQ paper to help those involved in criminal justice reform to better understand the potential positive impact of this important piece of legislation.
According to the JCCSG, those transitioning back into their communities have a much higher rate of disease and/or mental health issues. Diseases such as hepatitis, HIV/AIDS, diabetes, and asthma have been diagnosed in 50 percent of males and 66 percent of females who were released from prison. Those incarcerated are three to six times more likely than the general population to have been diagnosed with hepatitis c. The rate of HIV+ prisoners is four times as high. The JCCSG also reports that in a study of 20,000 inmates in five jails, 14.5 percent of men and 16.9 percent of women were diagnosed with serious mental illnesses.
The JCCSG paper, Implications of Federal Health Legislation on Justice-Involved Populations, attempts to answer questions concerned individuals might have regarding the PPACA. The following are highlights of the report:
Common barriers to obtaining health care for newly released inmates include not having employer insurance because 60 percent of returning individuals have a difficult time finding a job within one year of release, and the majority newly released individuals cannot afford to purchase healthcare insurance, as between 40-60 percent live in households with a yearly income of less than $20,000.
Current eligibility requirements for Medicaid dismiss low-income adults who do not have severe disabilities that prevent them from working. These requirements effectively preclude the majority of newly released individuals from obtaining Medicaid, but as of January 1, 2014, those requirements will change. On that date, those with an annual household income that is at or below 133 percent of the federal poverty level can obtain Medicaid without having a physical or mental disability.
In 2014 the federal government will pay 100 percent of the costs for newly eligible Medicaid recipients. By 2020, that amount will be reduced to 90 percent.
In 2014 Medicaid services must include “essential health benefits” including, but not limited to, preventative services, prescriptions, and mental health and substance abuse treatment and services. The latter is of particular importance to those with a criminal history, as substance abuse and mental illness are behind many criminal convictions.
Those who are incarcerated and cannot enroll in a state health insurance plan, but those who are incarcerated, but not yet sentenced may enroll.
Although the implementation of the PPACA will mandate that the majority of Americans obtain health insurance, those who are incarcerated for a month or more will be exempt during the period of incarceration.
State corrections departments are encouraged to work with health officials to ensure inmates are enrolled in Medicaid when they are released. Under the PPACA ,states must create a data base to determine the eligibility of soon-to-be released inmates to obtain Medicaid.
Community health care providers are asked to provide health care on a sliding fee scale to reentering individuals, and to help “streamline” applications from these individuals to obtain Medicaid. This year the PPACA will provide a substantial amount of funding for the creation of community healthcare centers and the expansion of existing ones.
Reentry programs are asked to establish and promote partnerships with community healthcare providers to better assure that newly released individuals are enrolled, in order to help with the transition between prison/jail and the community.
Although most of the PPACA changes in eligibility to enroll in Medicaid do not take effect until January 1, 2011, states have the option to expedite these changes.
To view the Justice Center’s Council of State Government report click here to go to website
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