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June 25, 2013

"Medicaid for prisoners: States missing out on millions"

The title of this post is the headline of this notable and lengthy USA Today article, which gets started this way:

Only a dozen states have taken advantage of a long-standing option to stick the federal government with at least half the cost of hospitalizations and nursing home stays of state prison inmates.  The other states have left tens of millions of federal dollars on the table, either because they didn't know about a federal rule dating to 1997 or they were unable to write the laws and administrative processes to take advantage of it.

States and localities have a constitutional obligation to provide adequate health care to prisoners, and they must pay for it out of their own budgets.  However, a 1997 ruling says that care provided to inmates beyond the walls of the prison qualifies for Medicaid reimbursement if the prisoner is Medicaid eligible.  The federal government then pays 50 percent to 84 percent of Medicaid costs.

Ever since that ruling, it has made fiscal sense to get inmates who needed outside medical attention enrolled in Medicaid, said Aaron Edwards, a legislative analyst in California who helped get the state's program started, "but in 2014 it really becomes a no-brainer."

That's when the major elements of the Affordable Care Act take effect, and most prison inmates will be eligible for Medicaid if they need health services outside of prison.  The number of inmates in state prisons as of 2011 was nearly 1.6 million, according to the U.S. Justice Department.  An additional 745,000 were in local jails, a population that would also qualify for Medicaid benefits if they required outside medical care.

Right now, in most states, only prisoners who are pregnant, disabled or aged are eligible for Medicaid coverage when they need outside medical attention.  But most states and localities don't bother to seek Medicaid reimbursement for that limited class of prisoners, an omission that deprives them of millions of dollars in potential federal reimbursement. It's not the inmates themselves but rather the states and localities that are the beneficiaries of the federal Medicaid reimbursement.

So far, only Arkansas, California, Colorado, Delaware, Louisiana, Michigan, Mississippi, Nebraska, North Carolina, Oklahoma, Pennsylvania, Washington and some scattered local governments are tapping Medicaid to pay for inpatient medical and nursing home care.  A few more states are looking into it, including Georgia, Massachusetts, Minnesota, New Mexico, New York and Virginia.

June 25, 2013 at 01:10 PM | Permalink


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Solution to spending too much money in the prison system = spend more money in the prison system.

You can't be logic like that.

Posted by: Bill Otis | Jun 25, 2013 3:38:11 PM

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