CALIFORNIA, USA — The federal government will allow Medicaid dollars to treat some people in prisons, jails or juvenile detention centers for the first time ever, the Centers for Medicare and Medicaid Services announced Thursday.
CMS will allow California inmates to access limited services, including substance use treatment and mental health diagnoses, 90 days before being released. Since Medicaid was established, federal law has prohibited Medicaid money from being used for people who are in custody, with inmates having access to their health care coverage suspended.
The move will provide more stability for inmates and juvenile detainees as they exit institutions and reenter the outside world, CMS administrator Chiquita Brooks-LaSure said Thursday.
She said the change will allow the state to "make unprecedented advancements for incarcerated individuals who have long been underserved."
At least 10 other states have asked CMS for exemptions to use Medicaid dollars to treat inmates before they are being released. California could be a model for those states, especially since the program is new territory for Medicaid and is expected to be a massive undertaking, said Vikki Wachino, who oversees the Health and Reentry Project at the Commonwealth Fund, a private foundation based in New York.
California state officials said Thursday that they hope some inmates will begin accessing services through Medicaid starting in 2024. Incarcerated people will be screened and assessed for eligibility to access the state's Medicaid program. If eligible, case workers will help them develop a care plan for reentry.
It will take at least two years to roll out the program in all the state's prisons, said Jacey Cooper, the state's Medicaid director.
Millions of people are expected to be affected, with California releasing nearly half a million inmates from state prisons or county jails every year and roughly 80% of those people qualifying for Medicaid.
People who are leaving prison, jail or juvenile detention often don't know where to start with getting medical care, Wachino said.
"Right now, there is an enormous barrier to care when people leave prison and jail," Wachino said. "As you know, many times when they're released, they've been left to fend for themselves, with very, very few supports."