title: Commentary: the importance of Medicaid expansion for criminal justice populations in the south.
abstract: Though the full implications of a Trump presidency for ongoing health care and criminal justice reform efforts remain uncertain, whatever policy changes are made will be particularly salient for the South, which experiences the highest incarceration rates, highest uninsured rates, and worst health outcomes in the United States. The passage of the Affordable Care Act (ACA) in 2010 was a watershed event and many states have taken advantage of opportunities created by the ACA to expand healthcare coverage to their poorest residents, and to develop partnerships between health and justice systems. Yet to date, only four have taken advantage of the benefits of healthcare reform. Expanding Medicaid would provide Southern states with the opportunity to significantly impact health outcomes for criminal justice-involved individuals. In the context of an uncertain policy landscape, we suggest the use of three strategies, focusing on advancing incremental change while safeguarding existing gains, rebranding Medicaid as a local or statewide initiative, and linking Medicaid expansion to criminal justice reform, in order to implement Medicaid expansion across the South.
authors.affiliation: Department of Health Behavior and Health Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, USA. ndzaller@uams.edu.
authors.forename: Nickolas D
authors.initials: ND
authors.lastname: Zaller
authors.affiliation: Vera Institute of Justice, Substance Use and Mental Health Program, New York City, NY, USA.|Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Cloud
authors.affiliation: Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA.|Center for Health Equity Research, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Brinkley-Rubinstein
authors.affiliation: Center for Prisoner Health and Human Rights, Providence, RI, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Martino
authors.affiliation: Brown University, Providence, RI, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Bouvier
authors.affiliation: Center for Prisoner Health and Human Rights, Providence, RI, USA.
authors.forename: Brad
authors.initials: B
authors.lastname: Brockmann