In the wake of the Supreme Court’s ruling in National Federation of Independent Business v. Sebelius comes this from John Jay College’s The Crime Report concerning the potential impact of the Patient Protection and Affordable Care Act on the incarcerated, an important question given that “an estimated 90 percent of the nation’s jail inmates and 85 percent of state and federal prisoners currently lack health insurance.”
Medicaid, which is paid for with state and federal funds, is currently mandated only for inmates who are under 21, over 65, disabled, or pregnant. Prison health care experts contacted for this story worried that at least in the short run, the costs of extending Medicaid to a larger number of inmates in states that are willing to accept the expanded program will strain a correctional system already having difficulty attracting physicians and other health professionals.
Many medical professionals simply do not find prisons and jails appealing places to work. That is one reason why the level of current care available in jails and prisons differs widely among states and localities and, some critics contend, is often of abysmal quality.
A related issue is how the availability of health care could help reduce recidivism:
Sick, formerly incarcerated people with health care access are less likely to recommit crimes that land them in prison, studies have shown.
“I don’t think the public recognizes…how much addiction issues [for example] drive a great deal of morbidity and mortality, the physical effects, and also drive street crimes, shoplifting, thefts, robbery, a lot of the gang-related violence, shooting deaths,” said Dr. Keith Barton, medical director for Correctional Health.
The prospect of less recidivism is one reason that even cash-strapped states should forge ahead with on the reforms, observers said.