Termination of Medicaid Policies and Implications for the Affordable Care Act

Birnbaum, Nathan; Lavoie, Melissa; Redmond, Nicole; Wildeman, Christopher; Wang, Emily A.

doi:10.2105/ajph.2014.302017

Cited by 8 publications

(4 citation statements)

References 4 publications

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“…Recently-released inmates are less likely to have a primary care physician and disproportionately use the emergency department for health care compared with the general population. Health insurance benefits, particularly Medicaid, may be terminated or suspended when a person is incarcerated, and a delay in reinstatement upon release often results in a coverage gap, resulting in delayed medical care (66–68). These gaps in resources and care upon re-entry to the community potentially increase one’s vulnerability to increased CVD risk and poor disease management…”

Section: Current Gaps In Knowledgementioning

confidence: 99%

Cardiovascular Disease in Incarcerated Populations

Wang

Redmond

Himmelfarb

et al. 2017

Journal of the American College of Cardiology

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Currently, 2.2 million individuals are incarcerated, and more than 11 million have been released from U.S. correctional facilities. Individuals with a history of incarceration are more likely to be of racial and ethnic minority populations, poor, and have higher rates of cardiovascular risk factors, especially smoking and hypertension. Cardiovascular disease is a leading cause of death among incarcerated individuals, and those recently released have a higher risk of being hospitalized and dying of cardiovascular disease compared with the general population, even after accounting for differences in racial identity and socioeconomic status. In this review, the authors: 1) present information on the cardiovascular health of justice-involved populations, and unique prevention and care conditions in correctional facilities; 2) identify knowledge gaps; and 3) propose promising areas for research to improve the cardiovascular health of this population. An Executive Summary of a National Heart, Lung, and Blood Institute workshop on this topic is available.

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Section: Current Gaps In Knowledgementioning

confidence: 99%

Cardiovascular Disease in Incarcerated Populations

Wang

Redmond

Himmelfarb

et al. 2017

Journal of the American College of Cardiology

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“…13 Nathan Birnbaum and coauthors report that nearly all criminal justice–involved individuals are now eligible for Medicaid upon release in Medicaid expansion states. 14 …”

mentioning

confidence: 99%

Leveraging The Affordable Care Act To Enroll Justice-Involved Populations In Medicaid: State And Local Efforts

et al. 2015

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The Affordable Care Act provides an unprecedented opportunity to enroll criminal justice–involved populations in health insurance, particularly Medicaid. As a result, many state and county corrections departments have launched programs that incorporate Medicaid enrollment in discharge planning. Our study characterizes the national landscape of programs enrolling criminal justice–involved populations in Medicaid as of January 2015. We provide an overview of sixty-four programs operating in jails, prisons, or community probation and parole systems that enroll individuals during detention, incarceration, and the release process. We describe the variation among the programs in terms of settings, personnel, timing of eligibility screening, and target populations. Seventy-seven percent of the programs are located in jails, and 56 percent use personnel from public health or social service agencies. We describe four practices that have facilitated the Medicaid enrollment process: suspending instead of terminating Medicaid benefits upon incarceration, presuming that an individual is eligible for Medicaid before the process is completed, allowing enrollment during incarceration, and accepting alternative forms of identification for enrollment. The criminal justice system is a complex one that requires a variety of approaches to enroll individuals in Medicaid. Future research should examine how these approaches influence health and criminal justice outcomes.

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“…Incarcerated people face serious barriers caring for themselves upon release, such as poor health literacy, limited access to housing and employment, and difficulties continuing their medications and accessing primary care [9]. Even in the 26 states that expanded Medicaid services by 2014 as part of the Affordable Care Act (ACA), many people have their Medicaid enrollment terminated upon incarceration, such that most are released without Medicaid and need to reapply [10]. That said, a growing number of states do enroll certain people in Medicaid upon incarceration or suspend their coverage as opposed to terminating the benefit [11].…”

Section: Incarceration and Health In The United Statesmentioning

confidence: 99%

What Does Health Justice Look Like for People Returning from Incarceration?

Puglisi¹,

Calderon²,

Wang

2017

AMA Journal of Ethics

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Access to health care is a constitutional right in the United States correctional system, and many incarcerated adults are newly diagnosed with chronic diseases in prison. Despite this right, the quality of correctional health care is variable, largely unmeasured and unregulated, and characterized by patients' widespread distrust of a health system that is intimately tied to a punitive criminal justice system. Upon release, discontinuity of care is the norm, and when continuity is established, it is often hindered by distrust, discrimination, poor communication, and racism in the health system. In this paper, we will propose best practices in transitioning from correctional-to community-based health care and argue that achieving health equity for people with criminal justice involvement in the United States is not possible without ethical provision of health care. CaseMr. C was released two months ago after a four-year prison sentence, shortly after having coronary artery bypass surgery for early onset atherosclerotic heart disease. At 42 years old, he was surprised and scared when his chest pain was diagnosed as a heart attack, necessitating major surgery while he was incarcerated. He was also told that there might be some problems with his kidneys, although he is unclear as to the specifics and does not have a copy of his medical records or his medications. Upon release he was homeless and has been staying with his mother in subsidized housing. This is a source of stress for her; because her son has a felony record, she worries that she is violating housing authority policy and could be evicted.During his first visit to the community clinic, Mr. C shares with Joe, his community health worker, and subsequently with the health care practitioner that he is fearful of being reincarcerated. He feels weak and has not followed through with cardiac rehabilitation because he doesn't have transportation. His parole officer tells him that if he remains unemployed he will be in violation of his parole. Mr. C's stress has brought on cravings for heroin, which he has not used since being incarcerated. Mr. C's clinician and community health worker wonder if there is anything they can do to help him.

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Termination of Medicaid Policies and Implications for the Affordable Care Act

Cited by 8 publications

References 4 publications

Cardiovascular Disease in Incarcerated Populations

Cardiovascular Disease in Incarcerated Populations

Leveraging The Affordable Care Act To Enroll Justice-Involved Populations In Medicaid: State And Local Efforts

What Does Health Justice Look Like for People Returning from Incarceration?

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