CMS approves waivers allowing incarcerated individuals to receive Medicaid coverage before release
By Noah Tong / July 2, 2024
The Department of Health and Human Services (HHS) is helping incarcerated adults and children obtain access to Medicaid or Children’s Health Insurance Program (CHIP) coverage before they leave a prison, jail or youth correctional facility.
The agency’s action July 2 will give coverage to people before they are released, minimizing gaps in coverage and better supporting individuals with often overlooked medical issues as they reenter the outside world. It applies to residents in Illinois, Kentucky, Oregon, Utah and Vermont.
“Expanding access to life-saving treatment and recovery supports for incarcerated people is a critical part of our bipartisan efforts to beat the overdose epidemic and save lives,” said Rahul Gupta, M.D., director of the White House Office of National Drug Control Policy, in a statement. “Under this important action today, the Biden-Harris Administration is providing a groundbreaking opportunity for these states to increase access to health care, including care for substance use disorder, in jails and prisons, and provide historically underserved and marginalized individuals with the tools and resources they need to succeed upon reentry.”
Under the Medicaid Reentry Section 1115 Demonstration Opportunity waiver, states can cover individuals through Medicaid and CHIP up to 90 days before they are released. States are also allowed to connect individuals to community-based providers.
Incarcerated people are found to have higher rates of substance use disorder and chronic conditions, the Biden administration said. They expect the waivers in these states will improve access to services, better address behavioral health needs and increase usage of long-acting injectable antipsychotics.
In total, HHS expects emergency department visits, inpatient hospitalizations and deaths will be prevented with more encompassing Medicaid coverage.
The Centers for Medicare & Medicaid Services said it is continuing to review application requests. Other states have already taken advantage of opportunities to support the incarcerated population, including California, Massachusetts, Montana and Washington.
Massachusetts approved a demonstration to provide 12 months of coverage on Medicaid and CHIP after a person is released from a correctional facility. That increases to 24 months if a person is chronically homeless.