Prison Inmates Received $7.7 Billion in Health Care Services Through Obamacare

Affordable Care Act created opportunity to expand coverage to incarcerated individuals

A doctor waits to be let into the California Medical Facility in Vacaville, Calif. / AP
• December 9, 2015 2:30 pm


Prison inmates received $7.7 billion in health care services in fiscal year 2011 through the Affordable Care Act, according to a recent report from Pew Charitable Trusts.

According to the report, in January 2014, Obamacare created an opportunity for states that expanded their Medicaid program by giving them additional federal funds, which made it easier for them to provide coverage for inmates. By making coverage available to all individuals, including non-disabled adults without dependent children who earn up to 138 percent of the federal poverty level, states could allow convicts increasingly to receive coverage.

"This eligibility expansion removes a key barrier so states and localities can enroll more inmates—or keep them enrolled during incarceration with suspended coverage—and can seek federal reimbursement for certain covered services," the report states. "The federal government is initially reimbursing 100 percent of the cost of covered services for all newly eligible enrollees, including inmates."

In addition, the Centers for Medicare and Medicaid Services urged states not to terminate coverage for inmates, but to suspend their coverage temporarily until they were released from prison. Officials say that allowing inmates to receive access quickly after incarceration "improves the individuals’ prospects for successful reintegration and benefits the public’s health and safety."

The report also finds that many of these offenders often have infectious diseases such as HIV and hepatitis as well as substance-use disorders and mental illnesses. Additionally, they may have chronic medical conditions such as hypertension and diabetes.

Prisons can also benefit from the Affordable Care Act by receiving financial support. If prisons enroll inmates in Medicaid, they can receive a 50 percent match of state expenditures. Assisting inmates with an enrollment application, helping them schedule appointments, referring them to medical providers and monitoring their progress with substance use treatment are just some of the ways prisons can be reimbursed.

Requests for comment from the Department of Health and Human Services and the Centers for Medicare and Medicaid Services were not returned by press time.