New Bill Looks to Tackle SUD Care Gap By Allowing Incarcerated Individuals Access to Medicaid Coverage

A group of U.S. lawmakers have introduced a new bill that could help incarcerated individuals access Medicaid 30 days before their release from prison or jail, giving them better access to behavioral health services.

The new legislation, dubbed The Reentry Act, would make it easier for Medicaid-eligible individuals to access services like substance use disorder (SUD) treatment and mental health care. It would do so while preventing the gap in health care coverage that previously incarcerated individuals often face once released.

While the legislation would not change who is eligible for Medicaid and CHIP coverage, it could help provide access to care for more people when released.

Advertisement

Senators Tammy Baldwin (D-WI) and Mike Braun (R-IN) and Representatives Paul Tonko (D-NY), Mike Turner (R-OH), John Rutherford (R-FL) and David Trone (D-MD) introduced the bipartisan legislation. The bill looks to change the current federal law permitting incarcerated individuals to have any form of federal health coverage, except in very limited circumstances.

Among its benefits, the senators introducing the bill say the legislation could cut down on post-release overdose deaths.

“In their first two weeks after release from incarceration, ex-convicts are 129 times more likely than the general public to die from a drug overdose,” Braun said in a statement. “The Reentry Act seeks to tackle the epidemics of opioid overdoses and recidivism after release from prison by resuming benefits for Medicaid-eligible individuals 30 days before they are released to avoid a gap in coverage.”

Advertisement

SUD disproportionately impacts incarcerated individuals. Approximately 85% of the prison population has an active SUD or were incarcerated for a crime involving drugs or drug use, according to the National Institute on Drug Abuse.

This isn’t the first effort to expand Medicaid access to incarcerated individuals.

The U.S. Department of Health and Human Services (HHS) approved an unprecedented 1115 demonstration amendment in California that allows Medi-Cal to cover SUD treatment before a Medicaid beneficiary is released from jail, prison or a correctional facility.

“For incarcerated individuals struggling with substance use disorders, transitional care is critical and can be life-saving,” Cooper Zelnick, chief revenue officer at Groups Recover Together, previously told Behavioral Health Business. “Historically, loss of Medicaid coverage upon incarceration has indeed been a key barrier for folks seeking substance use disorder treatment upon release.”

Founded in 2014, Groups Recover Together is a Boston-based opioid use disorder provider that operates on value-based care arrangements.

While this legislation focuses on the 30 days before release, many SUD have discussed the benefits of Medicaid coverage for incarcerated individuals.

“If [we] allowed incarcerated individuals … to retain their insurance, like their Medicaid or Medicare, or whatever insurance they have,” Meghann Perry, a recovery coach professional educator and person with lived experience of substance addiction and incarceration, previously told BHB, “we’d be able to provide them much better medical care and behavioral health care while incarcerated, which would really support them doing much better when they transition back into the community and not have that gap.”