Improving Healthcare Access Among the Newly Decarcerated

Abstract

The American opioid crisis has disproportionately affected our incarcerated population. Approximately two-thirds of inmates nationwide struggle with substance use disorders (Maryland Department of Health 2018; Cohn 2019). Though some receive treatment during incarceration, about 60% leave prison uninsured (Maryland Department of Health 2018). Without insurance, continuing treatment becomes improbable, significantly increasing the risk of overdosing in the two weeks following decarceration (Binswanger et al. 2007). The State of Maryland has addressed this problem by expanding Medicaid coverage under the Affordable Care Act in 2014. Today, an estimated 90% of Maryland prisoners qualify for Medicaid upon release (Hancock 2016). Despite Medicaid expansion and other measures, including a 2016 presumptive eligibility policy, most inmates still leave prison unable to access the healthcare for which they qualify (Cohn 2019). This memorandum highlights policy options that ensure eligible inmates leave with unencumbered access to healthcare. We recommend using Presumptive Eligibility to enroll all qualified inmates, which prevents a coverage lapse immediately following release, with implementation of full coverage for all state correctional facilities as the long-term goal.