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October 22, 2013

"Can Obamacare Reduce the Cost of Corrections?"

The question in the title of this post is the headline of this intriguing new piece by Graham Kates over at The Crime Report. Here are excerpts:

The Affordable Care Act (ACA) has the potential to dramatically reduce costs associated with incarceration and prisoner re-entry, a U.S. Department of Justice (DOJ) official said today at a conference on health care and corrections at the John Jay College of Criminal Justice in New York City.

Local and federal governments spend about $80 billion annually on corrections — about $35,000 per inmate, but Amy Solomon, an advisor to the DOJ’s Office of Justice Programs, noted that those receiving continuing healthcare beyond incarceration are significantly less likely to be re-arrested.

Beginning in 2014, Americans who earn up to 133 percent of the federal poverty line and reside in 25 states that have agreed to a Medicaid expansion will qualify for access to the government insurance program. Those who earn up to four times the poverty line will qualify for federally subsidized insurance. For impoverished former inmates re-entering their communities, Solomon said that could mean their first opportunities to pursue healthcare beyond bars. “Continuity of care is essential if we want to see health and safety benefits,” Solomon said....

And for communities struggling with the ravages of addiction, mental illness and other issues often relegated to the corrections system, it could mean opportunities to find less costly alternatives to incarceration. “I hope that judges will have viable community-based treatment options, so they won’t feel compelled to lock up someone with mental health issues,” Solomon said.

The key to diverting would-be inmates is separating low-risk offenders from those who are a high-risk, according to Elizabeth Glazer, former deputy secretary for public safety at the New York State Office of Criminal Justice Services. In New York State, 8 percent of offenders account for 80 percent of crime, Glazer said at the conference....

But for both low- and high-risk inmates currently in prison, the task of meeting healthcare needs upon release can be tricky. Few continue care with the provider they had in prison and healthcare often drops off entirely. New York recently unveiled a program called Medicaid Health Homes, which is designed to facilitate communication between all of an individual’s caregivers. For inmates re-entering local communities after prison stays, Glazer said the result will be an increased continuity of care. “Done right, fewer people are going back to jail and prison, and that’s sort of where the bigger incentive is,” Glazer said.

October 22, 2013 at 09:53 AM | Permalink


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I'm sure we all wish ex-prisoners well. When they want to sign up for Obamacare, I just hope they can break through the, "We're having a problem right now, please try later" message everyone else is getting.

Posted by: Bill Otis | Oct 22, 2013 10:18:19 AM

Mr. Otis, you wrote: "I just hope they can break through the, "We're having a problem right now, please try later" message everyone else is getting." I know lots of folks are having problems with the website--but my daughter signed up for Obamacare last week. After having been rejected by every insurance company for years because of pre-existing conditions, which nearly bankrupted our family, she now has insurance for the first time. I say CONGRATULATIONS to the President!!

Posted by: not a lawyer | Oct 22, 2013 11:57:27 AM

"Pre-existing conditions" clause amounts to welfare, not insurance. Otherwise, you can get into an accident, then buy insurance to pay for all the existing problems with your car that resulted from the accident. So let's make that aspect clear: If you are for taxes paying for your family memeber's condition so you can keep your beer money, so be it; just be upfront about it.

Back to Bill Otis: It is ironic that the care in prison, as bad as it is now, will be more efficient than Obamacare, which in reality is more of a new form of income/wealth tax than anything to do with health.

Posted by: Eric Knight | Oct 22, 2013 12:14:25 PM

not a lawyer --

I know, I know all these reports about rampant snafus -- reports in Republican shill outlets like the NYT, HuffPo and MSNBC -- are just so much right wing propaganda.

On the theory that your daughter is not an ex-con looking for the taxpayers to shell out yet more dough for her, however, congratulations and hats off for accomplishing a rare feat.

Posted by: Bill Otis | Oct 22, 2013 12:14:44 PM

Eric Knight --

Nailed it.

Posted by: Bill Otis | Oct 22, 2013 12:37:54 PM

Eric Knight, health care is not like auto insurance. A pre-existing condition is not an "accident." You'd sing a different tune if your daughter your daughter became sicker and sicker and couldn't get insurance--and and a a result, you were financially ruined . Her Obamacare insurance is not welfare. She has to pay premium ---a very Republican idea. And I once was a Republican--but not any more. And Mr. Otis, my daughter is not "an ex-con looking for the taxpayers to shell out yet more dough for her. She has a Ph.D in psychology from Brown. But thanks for the congratulations.

Posted by: not a lawyer | Oct 22, 2013 12:57:07 PM

not a lawyer --

The fact that your daughter is not an ex-con looking for the taxpayers to shell out yet more dough for her does not deflect in the slightest from the fact that people who ARE ex-cons will, on release, have their health care underwritten by the taxpayers. Thus the major point of this article -- that we can now reduce prison costs by releasing the (as ever) "low level" inmate, confident that he will have health care -- is just a shell game. It makes no difference if we're reducing prison costs paid by the public only to add those costs via Obamacare, which is paid for by THAT VERY SAME PUBLIC.

Whether the taxpayers are subsidizing healthcare inside prison or outside (which is what the Obamacare subsidies do, if anyone ever actually gets them) makes no difference. It's taxpayer money, one way or the other.

Posted by: Bill Otis | Oct 22, 2013 4:52:09 PM

Here is a simple arithmetic calculation. About a third of bed of jails across the country are filled by straight State Hospital grade chronic mental patients. They committed a nuisance crime, such as disturbing the peace on a bus. No one is posting the $100 bail needed to release them because the family feels everyone is better off with them in jail.

To the degree such patients are seeking care, will have new insurance, and will be less likely to land in jail from untreated mental symptoms, then the cost of corrections will decrease. Rough estimate half this population, including addicts. So universal care may drop the beds needed by one sixth. Because there will be no domiciliary cost, estimate a saving of $15 billion.

Posted by: Supremacy Claus | Oct 22, 2013 9:57:03 PM

not a lawyer stated: "Obamacare insurance is not welfare. She has to pay premium ---a very Republican idea."

Of course it is "welfare" because it is being subsidized by the American people who sign up and are healthy.

Even more damning/concerning is this. Your daughter has an Ivy League PhD. I do not believe for a minute that she cannot find a sufficient job (even in Obama's economy) with employer based health coverage. I suspect, and feel free to correct me if I am wrong, that she has (or had) her own practice and likes it that way. Where I come from, that is called a choice and not something I should have to subsidize. If she has been too sick to work at all, then Medicaid should have covered her.

Posted by: TarlsQtr1 | Oct 23, 2013 1:44:55 PM

The basic problem with the article has not yet been mentioned. It's the premise that inmates are incarcerated so that the rest of us can spend yet more tax dollars to pay their bills.

Nope. Prisoners are incarcerated as punishment for a serious offense. It is they who owe the debt to society, not the other way around. But in Eric Holder's upside-down DOJ, the public is the bad guy and the crook is the entitled victim, and thus licensed to yoke the rest of us to pay his bills for him.

Of course the way criminals get to think the way they do is by believing that others -- and never they -- are responsible for their lives. This is exactly the way of thinking that needs to be reversed, not encouraged.

Inmates are entitled to decent and humane treatment while in custody. When released, they can quit the whining and shirking and it's-everybody-else's-fault thinking, and go pay for their own lives and behavior, just as the rest of us do.

Posted by: Bill Otis | Oct 23, 2013 3:34:03 PM

Have to give bill this one!

Posted by: rodsmith | Oct 23, 2013 11:26:32 PM

Yes if they are in there for non violent crimes have a work history can get a job on the outside but the state wants to hold them for picking up a painted rock out of someones yard yes the state should have to pay their medical bills.

Posted by: vergie | Mar 10, 2014 7:41:47 PM

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