As states across the country struggle to cobble together the resources to address the opioid epidemic, one thing is clear: The current system is not working. One significant way that it is not working is in its failure to serve our addicted family members, neighbors and other fellow citizens who are churning in and out of jails and prisons. Furthermore, it is failing the taxpayers whose hard-earned money is being spent on reincarceration rather than saved through rehabilitation.
Health care is a fundamental human right that should never be stripped from any person, for any reason. The Medicaid program was established to provide health care for low-income Americans. When it became law in 1965, it included an exclusion policy that strips Medicaid-eligible individuals of coverage behind bars. At the time, our nation’s prison population was 200,000. Today, that number has risen tenfold, leaving nearly 2.2 million incarcerated individuals without access to appropriate addiction and mental health care.
This is a population that disproportionately suffers from substance abuse, and that problem has grown because of the opioid epidemic. While jails and prisons are required to provide health services to those in their facilities, such services are nowhere near comprehensive and rarely include the continuous, quality mental health and addiction treatment many need. Unless we address the underlying health issues of our justice-involved population, there is no hope for ending the vicious cycle of addiction for far too many Americans.
Repealing the Medicaid exclusion could help to ensure incarcerated individuals get much needed care. And it could save taxpayer dollars because those who get drug treatment before they are released are less likely to commit drug-related crimes and return to prison.
The Medicaid inmate exclusion policy has also placed an enormous financial strain on local governments. In fiscal year 2015 alone, states spent approximately $8.1 billion on health care for incarcerated individuals — even as many continue to struggle with untreated physical and behavioral health challenges upon release. At its core, this policy is an unfair and outdated law that shifts the cost of care from the federal government to local communities and states.
In New Hampshire, we have seen real evidence that providing quality health care can reduce recidivism rates and save local government tax dollars. More than 10 years ago, officials in Sullivan County, N.H., were considering building a new jail at a cost of $42 million as the number of people housed in the county jail had expanded beyond its capacity. On the precipice of what would become a full-blown public health emergency fueled by opioids, the county instead decided to invest $7.1 million to create a new program that, among other things, would provide mental health counseling and substance abuse and addiction programs to those in jail. In seven years, the reincarceration rate for those formerly incarcerated in the Sullivan County jail dropped from 54 percent to only 18 percent.
In New Jersey, one of the the nation’s first medication-assisted treatment program for incarcerated individuals began in July 2017 Since then, more than 750 individuals behind bars have received treatment and referrals, and the program’s participants have a lower rate of recidivism upon release than the general population at the Atlantic County jail.
These successful programs illustrate the positive impact on individuals and communities when we provide quality care to incarcerated men and women. With proper care, incarcerated individuals who are struggling with substance use disorders, mental illnesses and other health issues have a better chance of returning to their communities and successfully reentering life outside prison walls. Simply put, these programs strengthen communities and save lives and tax dollars.
Addiction and untreated mental health needs in our criminal-justice system have heartbreaking consequences for individuals, families and loved ones, and are a waste of human potential and taxpayer dollars. We need to break this vicious cycle — and repealing the Medicaid inmate exclusion is an important step. That’s why, together, we wrote the Humane Correctional Health Care Act, which we introduced in the House and Senate in July.
Repealing this exclusion will improve health care and treatment delivery for those behind bars, reduce recidivism rates across the country, and save local taxpayer dollars. And as we continue to battle an opioid epidemic that has wreaked havoc across our communities, it would provide Americans who are struggling an opportunity to recover and live up to their full potential.