Headline
Louisiana improved Medicaid enrollment and health care access for people reentering communities from state prisons.
Context
The weeks following a person’s transition from incarceration back to the community presents significant health risks. This population disproportionately experiences higher rates of chronic and infectious disease and faces a high mortality rate in the weeks following release, especially related to drug overdose. Medicaid coverage can support this population in accessing needed health care services upon reentry; however, federal policy requires the termination of Medicaid coverage when a person enters into incarceration.
This study examines Medicaid coverage before and after implementation of a Louisiana state prisons program that sought to enroll/re-enroll eligible adults within nine months of release from prison, as well as encourage these individuals to use of health services post-release. The program was implemented after Louisiana expanded Medicaid under the Affordable Care Act.
Findings
Using state corrections and Medicaid data across the 30-month study period, the authors found that Medicaid enrollment at the time of release significantly increased from 38% pre-program implementation to 72% post-program implementation. A subset of this group lost coverage post-release, typically related to non-response to requests for information. Of program participants enrolled in Medicaid at the time of release, 99% had at least one outpatient visit within six months.
Additional qualitative findings from program participants and staff highlighted high program satisfaction, as well as the need for improvements in pre-release case management scheduling, corrections-based health care screening, pre-release education about Medicaid benefits, and health care services during incarceration.
Takeaways
This study provides valuable insights for state policymakers looking to address the disproportionate health burdens and barriers to health care that this population faces. Additionally, the study contributes to the growing body of evidence indicating that providing pre-release Medicaid enrollment support improves justice-involved individuals ability to access care in the community. With recent federal legislation requiring states to suspend, rather than terminate, Medicaid coverage during incarceration as soon as 2026, these findings point to the benefits of ensuring pre-release Medicaid enrollment for individuals in correctional settings, including for those who were not enrolled prior to incarceration.