title: Leveraging The Affordable Care Act To Enroll Justice-Involved Populations In Medicaid: State And Local Efforts.
abstract: 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.
authors.affiliation: Sachini N. Bandara (sbandar2@jhu.edu) is a doctoral student in the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland.
authors.forename: Sachini N
authors.initials: SN
authors.lastname: Bandara
authors.affiliation: Haiden A. Huskamp is a professor of health care policy at Harvard Medical School, in Boston, Massachusetts.
authors.forename: Haiden A
authors.initials: HA
authors.lastname: Huskamp
authors.affiliation: Lauren E. Riedel is a research assistant at Harvard Medical School.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Riedel
authors.affiliation: Emma E. McGinty is an assistant professor in the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health.
authors.forename: Emma E
authors.initials: EE
authors.lastname: McGinty
authors.affiliation: Daniel Webster is a professor in the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health.
authors.forename: Daniel
authors.initials: D
authors.lastname: Webster
authors.affiliation: Robert E. Toone is an attorney in West Newton, Massachusetts.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Toone
authors.affiliation: Colleen L. Barry is an associate professor and associate chair for research and practice in the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health.
authors.forename: Colleen L
authors.initials: CL
authors.lastname: Barry
mesh_terms: D006297:Health Services Accessibility; D006801:Humans; D019458:Insurance Coverage; D008484:Medicaid; D058991:Patient Protection and Affordable Care Act / Q000331:legislation & jurisprudence*; D011329:Prisoners; D011330:Prisons; D012935:Social Justice; D014481:United States
keywords: Insurance Coverage < Insurance; Medicaid; State/Local Issues