The Build Back Better bill is transformative legislation. And if he can be recovered after Senator Joe Manchin brutally tried to end negotiations with his party on the bill, he could be the cornerstone of Joe Biden’s presidency, given his ambitious policies of fight against climate change and strengthen the social safety net. The fate of the bill also encompasses its lesser-known provisions – small tweaks and improvements to existing programs – many of which could also improve people’s lives in tangible ways.
One of those small-scale articles that has been locked down on Build Back Better is the Return to Medicaid Act – a proposal to allow Medicaid to start covering people who are serving their last 30 days in prison or in prison. Under the current system, inmates cannot benefit from Medicaid coverage, even if they participated in the program prior to their incarceration. And as is often the case, re-entering the social program is proving to be a difficult task in many states, take weeks or even months for the health benefits of a former inmate to resume.
But just because Build Back Better is on life support – but not dead yet – doesn’t mean the Medicaid Reentry Act has come to the end of the road. Rather, it opens up an opportunity for Congress to tackle this problem head-on, either by tying it into another piece of legislation or by mobilizing bipartisan support for another round of criminal justice reform. Either way, Congress should make sure not only to pass the Medicaid Reentry Act, but also to broaden its ambition and to improve prison health services more broadly.
There is an urgent need to pass the Medicaid Reentry Act, as it currently exists: when people are released from prison, they face a much more risk have serious health problems or die than the general population, especially during their first two weeks of return to a free society. This is partly because people in prison are already more likely to suffer from health problems, from diabetes mental illness substance use disorders. But it is also because upon release from prison, finding medical care or treatment is not easy. In some cases, people will lose access potentially life-saving drugs.
Ensuring that people continue to access the care they need, with minimal or no disruption, is the least government can do to protect those for whom it is responsible. This is not only the right thing to do, but it would also lead to better and cost-effective results for public health and safety. Improving access to medical care has been shown to reduce recidivism rates for people formerly incarcerated. For example, a A Yale researcher has found that former inmates with access to health care were less likely to have mental health or substance abuse issues that might otherwise return them to prison.
But while the Medicaid Reentry Act is a step in the right direction, it is far from sufficient to address the serious health problems associated with a prison sentence. For starters, this would only allow inmates to access Medicaid benefits during their last 30 days behind bars rather than ending the suspension or termination of those benefits if imprisoned.
American prisons also regularly provide substandard care for their inmates, sometimes in flagrant violation of international law, which requires that incarcerated people receive the same medical care and treatment as the general public. And while it is true that sometimes being sent to jail may be the first time someone is diagnosed with a chronic health condition that they may have previously had – a clear sign that the health system in their midst. together also leaves a lot to be desired – prison overcrowding and a lack of financial investments lead to many prisoners receiving inadequate care. Therefore, any plan to improve the health of prisoners, both behind bars and beyond, should also devote the necessary resources to improving prison conditions.
Ultimately, Congress should realize that the government’s responsibility to those under its care does not end once they are released from prison. Act as if this makes prison all the more disruptive in someone’s life by actively choosing to make bad outcomes more likely for those formerly incarcerated. It not only fails these individuals, but it does not fail their larger communities. If public safety is really about ensuring a safer environment, then improving public health outcomes is a given – as is the Medicaid Reentry Act.
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