How Medicaid Expansion To Ex-Offenders Affects Big CA County


Many inmates leave county jails and state prisons with mental health problems and chronic physical ailments, and no health coverage, says Kaiser Health News. Because they typically are not custodial parents, ex-offenders have long been ineligible for a public health insurance program aimed at kids, mothers and the disabled. Earlier this year, California and 25 other states, under a provision of President Obama's health law, opened up Medicaid to single and so-called “childless” adults. The change in eligibility criteria will extend Medicaid coverage to vast numbers of ex-offenders whose incomes are below the federal poverty line.

“Historically, 10 or 11 percent of folks in detention have been eligible for Medicaid,” said Alex Briscoe, health director for Alameda County. “That number is well over 90 percent as of January.” Indeed, of those newly eligible under the Medicaid expansion, experts predict one out of three nationally will be former inmates or detainees. Alameda County estimates that 18,000 offenders in its two jails will qualify. Men and women involved in the criminal justice system are more likely to be sicker than the general population, with higher rates of diabetes, hypertension, depression, mood disorders and alcohol and drug addiction. Many have spent years—perhaps their entire adult lives—without health insurance and have medical conditions that must be stabilized when they're incarcerated. At Santa Rita jail in Dublin, one of the largest U.S. detention facilities, the pharmacy dispenses some 350,000 prescription drugs each month and spends $28 million each year on medical and mental health services. Because recidivism rates are so high in Alameda County—two out of three inmates re-offend—the jails' medical clinics often end up re-stabilizing the same inmates.

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