Parole and probation systems in the U.S. do not effectively serve people with chronic health conditions, and building on Medicaid on the state level, rather than taking it away, would improve the health of people leaving prison and jail and would help reduce mass incarceration, says a new report from the Square One Project of Columbia University.
The report was issued as the Supreme Court heard arguments on the constitutionality of the Affordable Care Act. If the law were struck down, millions of families could lose access to health care.
“Health and justice are so closely intertwined that we cannot effectively reduce mass incarceration without also ensuring access to health care,” said Lynda Zeller, primary author of the report. “Individuals with chronic health conditions will continue to be over-represented in the justice system, suffer high rates of re-incarceration, and remain incarcerated for longer periods of time if they do not have access to adequate health care.”
Millions of Americans, many of whom have recently left jails and prisons, receive health care through Medicaid; 38 states and the District of Columbia have expanded Medicaid or passed ballot measures to do so.
If the ACA is struck down, so will be the Medicaid expansion, and formerly incarcerated individuals will be left uninsured and unable to get the care they need.
An estimated 80 percent of people released from incarceration in the U.S. have a substance use disorder, mental health illness, or physical health condition. Failing to address their health needs can often lead to higher rates of recidivism, and complicates their ability to find jobs and reintegrate into society, the Square One report says.
Colorado, Texas, and North Carolina have used grant money to expand mental health care and substance abuse treatment for people who have served time behind bars. These states also saw large drops in recidivism, says the report.
North Carolina had a 42 percent reduction in people sent back to prison after probation violations between 2006 and 2015.
Texas reported a 25 percent reduction in the three-year reincarceration rate between 2004 and 2013.
Colorado saw probation revocations and the three-year reincarnation rate reduced by at least 23 percent in the same period.
“Criminal justice reform is often centered around sentencing, policing and other incremental tweaks but the true path to justice and to safety means making our social safety net robust and strong,” said Katharine Huffman of the Square One Project.
“If we ensure everyone has access to quality physical and mental health care, including people recently released from incarceration, we’ll have stronger, safer and healthier neighborhoods.”