Most inmates qualify for expanded Medicaid under the Patient Protection and Affordable Care Act, and Medicaid applications can be made at any time, not just during the annual sign-up period. Officials told Kenning that after the first four days, they had processed 18 applications, mostly for Medicaid.
The benefit to prisons and jails is twofold: Inmate hospitalizations lasting more than 24 hours can be billed to Medicaid, and getting coverage for released inmates provides insurance to a population that has a high rate of chronic disease, substance abuse and mental illness — conditions that often bring them back to prison, Kenning writes.
This treatment is often only a temporary fix, because repeat offenders fail to continue their treatment when released because of a lack of health insurance, officials acknowledged.
“I know some people will think, ‘I can’t afford health insurance myself. Now a person in jail gets access to health care?'” Mark Bolton, director of Metro Corrections, told Kenning. “But taxpayers are paying for these people anyway.”
Kenning reports that in Louisville, “Metro Corrections’ health care costs make up $9 million of its $52 million budget — a result of treating medical conditions including diabetes, heart disease, infections and drug problems.” The jails house an average of about 2,000 people.
U.S. Sen. Mitch McConnell does not support the signups, telling The Courier-Journal that it adds burdens to an already strained Medicaid program that is hard-pressed to find enough doctors willing to accept Medicaid patients. “This is yet another disturbing aspect of a profoundly troubling piece of legislation,” he told Kenning.
Plans to expand to other jails and other parts of the state are in the works, said Barbara Gordon of the Kentuckiana Regional Planning and Development Agency, a Louisville-area government clearinghouse that provides “Kynectors” to help people sign up on Kynect, the state health-insurance exchange. They now spend two hours a day at the jail and hope to eventually have someone there full time, Bolton told Kenning.
About a third of people going in or out of prisons and jails would qualify for expanded Medicaid, and 24 percent would qualify for subsidized private insurance, estimates Dr. Fred Osher, director of health systems and services policy for the nonpartisan Council of State Governments Justice Center.
The state Department of Corrections projects that by shifting the costs of those 24-hour hospital stays to Medicaid, the state prison system would save more than $5 million a year, Kenning reports. The system has seen health costs rise to more than $54 million this year, from $34 million in 2004.