At Least 38 States Charge Prisoners Co-Pays For Medical Care


Going to prison doesn't spare patients from having to pay medical copays. In response to the rapidly rising cost of providing health care, states are increasingly authorizing the collection of fees from prisoners for medical services they get in state prisons or local jails. At least 38 states now do it, says the Brennan Center for Justice at New York University School of Law and Stateline. The fees are typically small, $20 or less. States must waive them when a prisoner is unable to pay but still needs care, in keeping with a U.S. Supreme Court ruling that prisoners have a constitutional right to “adequate” health care.

The rationale for charging copays is the same for prisoners as it is for people not behind bars: to discourage seeking medical care when it is not really needed. “We do it for the same reason your insurance company does — to eliminate abuse by making the inmates put a little skin in the game,” said Tommy Thompson, jail administrator at the Rutherford County Sheriff's Office in Tennessee. Critics argue charging fees may cause ill inmates to forgo treatment, which can lead to worsening health and higher medical costs down the road as well as the possibility of spreading infections in the close quarters of prison. “There are ways to deal with high demand other than copays, which are punitive,” said Robert Greifinger, the former chief medical officer of the New York Department of Corrections. “It may not seem like a lot of money but, typically, the prisoners are impoverished and, often, so are their families,” Greifinger said. “Sometimes, their choices come down to a medical appointment or shampoo.”

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