Medicaid Expansion Shifts Focus to Improve Re-Entry and Community Transitions – Erick Allen Eiting
Mass incarceration has had a significant impact on urban America. Los Angeles County and New York City represent the largest municipalities in the country, and they also have some of the highest incarceration rates. Both New York and Los Angeles have taken recent steps to improve the health and healthcare provided to their inmates. Rikers Island in New York had previously contracted out its correctional healthcare to a private company. Last spring, Mayor Bill de Blasio shifted this care to Health and Hospital, the network of public hospitals and clinics in New York City. Similarly, the Los Angeles County Board of Supervisors voted to move correctional care to its Department of Health Services, a similar healthcare network that provides public medical care.
Several provisions in the Affordable Care Act (ACA), often referred to as Obamacare, were major drivers in these decisions. The Medicaid expansion under the ACA includes several provisions that make it easier for inmates to qualify for insurance while they are incarcerated. This has shifted the focus of many providers to improving the re-entry process to society for released inmates, reducing recidivism and addressing the social determinants of healthcare for these patients. All eyes will be on these two large, urban areas to see the impact of this expansion. Medicaid coverage is only the first step. Inmates will need appropriate community transitions and treatment options to ensure access to housing, substance abuse treatment and mental health care to have a significant impact on mass incarceration. PfCJR salutes these two cities for their progressive, patient-focused approach to this issue.