The HARP Team has developed and contributed to the following materials providing background on Medicaid, reentry, and related issues. Please check back frequently as we will continue to add briefs, reports, blogs, and other information from the HARP network.
Issue Brief: Paving the Path to Healthier Reentry: How New Medicaid Policies Can Improve Mental Health and Substance Use Support as People Return to Communities (October 2023)
New policies that allow Medicaid to cover some services prior to people being released from prison or jail have the potential to improve the health and wellbeing of people with mental health and substance use conditions, who are overrepresented in the criminal justice system. This new brief describes these changes and the opportunities they create to improve care for people with mental health conditions and substance use disorder as they return to communities.
New Reports Recommend First-Ever Approach to Medicaid Coverage of Services for Opioid Use Disorder in Prisons and Jails
Viaduct Consulting LLC, led by HARP Executive Director Vikki Wachino, released two a first-of-their-kind reports:
The first report, Recommendations for Medicaid Coverage of Opioid Use Disorder Services in Jails and Prisons (October 2023), recommends ways to advance quality, evidence-based services for opioid use disorder in state prisons and local jails by allowing Medicaid to cover those services. This report is the first to recommend specific services and standards that Medicaid could cover in a prison or jail setting and comes as groundbreaking new Medicaid policies to cover some services provided in prisons and jails are taking place. Find additional information on this report in a recent press release from HARP and recent blogs from The Pew Charitable Trust and The Milbank Memorial Fund.
The second report, Recommended Medicaid Performance Measures for Opioid Use Disorder in Jails and Prisons (November 2023), recommends performance measures for states and the federal government to use assessing efforts to provide OUD services, including MOUD, to Medicaid beneficiaries in jails and prisons and reentering the community. Find additional information on this report in a recent blog by The Pew Charitable Trust.
Fact Sheet: Medicaid’s New Role in Advancing Reentry: Key Policy Changes (August 2023)
This 2-page fact sheet provides an overview of groundbreaking new reentry policies that are taking effect as well as proposed federal legislation under current deliberation by Congress.
Issue Brief: Breaking Ground: How California is Using Medicaid to Improve the Health of People Leaving Incarceration (May 2023)
CMS’s January 2023 approval of California’s Medicaid Section 1115 Demonstration Waiver represents the first real-world pilot of using Medicaid to cover some services in jails and prisons prior to a person’s release from incarceration. This brief provides an overview of California’s groundbreaking new reentry reforms and examines their potential impacts, anticipated implementation issues, and implications for other states considering similar reforms.
Issue Brief: Redesigning Reentry: How Medicaid Can Improve Health and Safety by Smoothing Transitions from Incarceration to Community (July 2022)
What support helps people successfully navigate release from incarceration so that they can return to their community “healthy and whole”? How can changes to Medicaid’s role at reentry facilitate smoother transitions from carceral to community settings? This stakeholder-informed brief synthesizes the perspectives of over 70 people from diverse backgrounds, experiences, and perspectives to identify key principles for changing Medicaid’s role at reentry, propose a new care model to support successful reentry, and share essential elements for successful policy implementation.
Issue Brief: Medicaid and Reentry: Policy Changes and Considerations for Improving Public Health and Public Safety (March 2022)
Recent Medicaid policy advances propose to change the relationship between Medicaid and prisons and jails. This background brief provides a 101 on Medicaid and Reentry, including an overview of how Medicaid operates, the role it plays within the healthcare system, and its current role for the carceral population. It also summarizes recent policy changes and proposals and identifies key policy implementation issues.
Hosted by HARP and Council on Criminal Justice (CCJ), this 4.27.23 webinar discusses CMS’ groundbreaking new reentry guidance, which offers states a roadmap for using Medicaid to strengthen health care at reentry and improve people’s health and wellbeing as they leave prison and jail. The webinar features HARP founder and executive director Vikki Wachino in conversation with Daniel Tsai, CMS Deputy Administrator and Director of the Center for Medicaid and CHIP Services; Amy Solomon, Principal Deputy Assistant Attorney General at the U.S. Department of Justice; Juliana Stratton, Lieutenant Governor of Illinois; and Khalil Cumberbatch, Director of Strategic Partnerships at the Council on Criminal Justice.
CMS Opens Door for Pre-Release Services for Justice-Involved Populations: Health Care and Justice System Implications
This 3.27.23 webinar, hosted by the Center for Health Care Strategies (CHCS) and the Council of State Governments Justice Center (CSG Justice Center), provides a brief background on how California’s waiver to expand pre-release services and the CalAIM Justice-Involved Initiative will address health equity in the criminal justice system. The virtual panel features HARP founder and executive director Vikki Wachino; Allison Hamblin, CHCS President and Chief Executive Officer; Autumn Boylan, Deputy Director at California Department of Health Care Services; Liz Buck, CHCS Senior Program Officer; Brenda Graelish, Executive Officer, Council on Criminal Justice and Behavioral Health, California Department of Corrections and Rehabilitation; and Ayesha Delany-Brumsey, former Behavioral Health Division Director, CSG Justice Center.
- Providing Health Care at Reentry Is a Critical Step in Criminal Justice Reform – Commonwealth Fund To the Point Blog
- A healthier path out of prison leads to safer communities – The Hill
- Medicaid should cover the incarcerated – Commonwealth Magazine
- The Health and Reentry Project on Medicaid’s Groundbreaking Policy Guidance – Interview with RX Foundation
- Health care often takes a back seat after incarceration. Here’s how some states are working to change that – PBS Newshour
- Health, Incarceration, and the Intersection of Medicaid Policy – Georgetown Public Policy Review
- The Push to Bring Medicaid Behind Bars – Tradeoffs
“Medicaid has the potential to connect eligible people leaving jails and prisons to services that can maintain or improve their health and mental health, financial security, and ability to participate fully in their families, their communities, and the workforce”
What is Medicaid’s role in addressing the health needs of people returning to communities?
Medicaid is the nation’s publicly-financed insurance program for people with low incomes. People who have low incomes – as well as people of color – are more likely to be incarcerated than are other people. Consequently, many people who are incarcerated are eligible for Medicaid. However, Medicaid has historically been prevented from covering services for people who are incarcerated due to a federal law known as the “inmate exclusion.”
States and jurisdictions have increasingly identified the inability to reach into prisons and jails as a barrier to getting people the health, mental health, and substance use services as they transition from incarceration to the community. Recently, policies have been gaining traction at the state and federal level to address that historical barrier. Medicaid has the potential to connect eligible people leaving jails and prisons to services that can maintain or improve their health and mental health, financial security, and ability to participate fully in their families, their communities, and the workforce. Medicaid coverage has also been associated with positive public safety outcomes and reduced recidivism.