As many as four million former convicts in America may soon get health coverage as part of the expansion of the Affordable Care Act’s expansion of federal medicine.

The expanded coverage will provide a continuity of care for millions of people that analysts say will ultimately save the government money in lowered public health costs and a sharply reduced recidivism rate, say analysts at the George Washington University. In a report published in the journal Health Affairs, Marsha Regenstein, a professor of public health, says new coverage eligibility may dramatically improve some communities in the United States.

"Health reform gives people with a history of jail time access to continuous health care for the first time ever," she told reporters in a statement. "The hope is that such coverage will help keep individuals and entire communities healthier and reduce the nation's health care costs."

In studying the issue, Regenstein and her colleagues focused not on federal or state prison but on the millions who’ve served time in more than 3,200 county and local jails across the country. Typically, inmates with mental health and substance abuse disorders receive diagnoses and care while in the clink, only to be released without follow-up attention. As such, the cycle of arrest and incarceration continues for many as a revolving door.

Although the ACA doesn’t specifically address the prison population, the expansion of Medicaid will inevitably help many former inmates, says Sara Rosenbaum, a professor of health law and policy at the university. "The Affordable Care Act doesn't change that responsibility but it does mean that many in the jail population will be able to get health coverage before and after time spent in the local jail," she said.

With continuous medical coverage, people with serious mental illnesses may receive treatment — including prescription medication — that would help them to better function in society. Nearly two-thirds of people sent to jail suffer from some sort of mental illness at the time of their arrest and booking, the researchers noted.

Without addressing root problems often involving health issues, many former inmates will return to jail, sicker than ever. Rosenbaum says state and local prison officials should begin working with Medicaid to identify those eligible for programs expanding in 25 states. “Enrolling people who are to be released from jail will require substantial effort and resources," Rosenbaum said. "However, this investment will pay off in terms of better health, reduced costs and possibly the reduced risk of additional jail time."

Such an evolution in care may take some time, however, as most U.S. jails still have yet to digitize their record-keeping.

 

Source: Marks JS, Turner S. The Critical Link Between Health Care and Jails. Health Affairs. 2014.