Fox: Enrolling Exiting Inmates In Medicaid “Unfair To Every Taxpayer”

Fox Contributor: Signing Up Exiting Inmates For Medicaid Is “Ridiculous And Unfair To Every Taxpayer.” The April 7 edition of Fox News' America's Newsroom debated whether it is “smart money” to cover former inmates through Medicaid. Fox contributor Tony Sayegh called enrolling inmates in Medicaid “a loophole of Obamacare” that makes “absolutely no sense,” going on to claim:

SAYEGH: The fact that you are putting on the same level, a working poor person who needs to benefit from the expansion of Medicaid and an inmate, who breaks the law and for whom crime pays by giving them Medicaid benefits at taxpayer expense for life, is ridiculous. [Fox News, America's Newsroom, 4/7/14]

Experts: Signing Up Exiting Inmates For Medicaid Saves Money, Lowers Recidivism

Kaiser Family Foundation: Access To Medicaid Helps Reduce Recidivism Rates. Kaiser Family Foundations' health news noted that former prisoners who were given access to health care services, such as Medicaid, were more successful in staying out of prison:

Potentially far more important for the state's bottom line, Medicaid expansion will also cover low-income inmates leaving prison.

“Having access to health care and mental health care contributes to their success in staying out of prison,” noted Heidi E. Washington, warden at the Charles E. Egeler correction facility in Jackson, Mich.

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Helping former inmates adjust to the outside world has been shown in many studies to curb recidivism. Michigan, which has used state funds for reentry programs that include health care for nearly a decade, has seen its prison population drop in the past five years from 51,554 to 43,636. For released offenders with special needs--mostly mental disorders--recidivism rates plummeted from 50 percent in 1998 to 22.5 percent in 2012. Michigan spends $35,000 each year for every imprisoned inmate. [Kaiser Health News, 12/4/13]

Governing: “Medicaid Expansion Can Lower Prison Costs, Recidivism.” A November 26, 2013, article in Governing magazine noted that enrolling exiting inmates in Medicaid greatly reduces health care costs and highlighted research showing that “immediate access to health care upon release helps reduce recidivism”:

States are eager to combat rising prison health costs driven by an aging population, logistical challenges and a high incidence of chronic diseases. In a Pew Study examining prison health costs between 2001 and 2008, per-inmate spending rose in 35 of 44 states, with 32 percent median growth. That same study cited reports from state health agencies that found Medicaid expansion would save hundreds of millions over a decade from inpatient care in outside health facilities. In Ohio, it's $273 million between 2014 and 2022. In Michigan, it's $250 million in the law's first decade. 

But in addition to those savings, states are eying relief to a more intractable problem: recidivism, or the rate at which ex-offenders commit new crimes that land them back in the prison system. Studies have shown that, particularly with ex-inmates with severe mental health or substance abuse issues, immediate access to health care upon release helps reduce recidivism. A 2007 study of two counties in Florida and Washington over a two-year period linked access to Medicaid with a 16-percent reduction in the average number of subsequent lock-ups.  [Governing, 11/26/13]

The Sentencing Project: Medicaid Expansion Can Lower Corrections Expenditures, Reduce Incarceration And Recidivism. The Sentencing Project explained that the expansion of Medicaid under the ACA could lead to treatment services for inmates that could reduce correctional costs and decrease incarceration:

The expansion of Medicaid means that states can essentially use federal Medicaid funds to increase treatment services that could reduce incarceration and recidivism

and, in doing so, potentially lower associated local and state corrections expenditures. Research shows a direct relationship between county levels of funding for drug and  alcohol services and courts sentencing people to intermediate sanctions rather than jail or prison.18 Other evidence suggests that drug treatment significantly reduces

criminal activity, incarceration, and recidivism.19 Accordingly, states and local governments that cover costs for jails and prisons can potentially benefit indirectly

from expanded Medicaid eligibility through fewer people entering jails and prisons for crimes related to substance abuse and mental health problems and from decreases in recidivism rates. Pre-release and reentry programs might also be better able to connect people who are leaving jail or prison with community-based intervention services.

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The ACA is not a panacea - it will not eradicate the societal factors that contribute to excessive poor health among African Americans and other minorities, nor will it eradicate other biases within the criminal justice system that contribute to disparate rates of incarceration. It does, however, pose an opportunity to level at least one dimension of the playing field - access to treatment for mental illness and addiction- two problems that increase the likelihood of arrest and recidivism. In doing so, it may help reduce racial/ethnic disparities in incarceration. [The Sentencing Project, September 2012]