PROVIDENCE, RI It is time for states to suspend, rather than terminate, the Medicaid benefits of inmates while they are incarcerated, say correctional health care experts from The Miriam Hospital in a commentary published online by the Journal of General Internal Medicine.
Although federal law does not mandate Medicaid termination for prisoners, 90 percent of states have implemented policies that withdraw inmates' enrollment upon incarceration, which the authors say leaves a vulnerable population uninsured following release.
In the article, Josiah D. Rich, MD, MPH, notes that each year, the United States releases more than 10 million people from the nation's correctional facilities. Re-entry into the community for former inmates is a vulnerable time especially for those with mental illness and is marked by difficulties adjusting and increased drug use. In addition, the risk for dying is sharply increased in the first two weeks after release, with drug overdose, cardiovascular disease, homicide and suicide among the leading causes of death.
"We know that having Medicaid at the time of release leads to increased access to and utilization of services, as well as decreased drug use and re-incarceration. However, without coverage, former inmates face tremendous, and potentially fatal, health risks and are forced to rely on emergency rooms for medical care, placing the burden of cost on hospitals and state agencies," says Rich, co-director of the Center for Prisoner Health and Human Rights at The Miriam Hospital and The Warren Alpert Medical School of Brown University.
He also points out that releasing inmates without medical coverage can contribute to an increased spread of infectious diseases, since many prisoners with hepatitis C, HIV and tuberculosis pass through the correctional system. Other communicable diseases, such as influenza, are commonly spread in prisons.
Although Medicaid has prohibited the use
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