The U.S. Department of Health and Human Services (HHS) has authorized Illinois, Kentucky, Oregon, Utah, and Vermont to provide Medicaid and Children’s Health Insurance Program (CHIP) coverage to individuals transitioning out of incarceration up to 90 days before their release, as announced last week. This move has been met with support from several healthcare leaders.
This initiative, known as the Medicaid Reentry Section 1115 Demonstration Opportunity, allows states to cover services such as substance-use disorder treatment before release. States can also connect individuals leaving incarceration to community-based Medicaid and CHIP providers. By joining Illinois, Kentucky, Oregon, Utah, and Vermont, these states follow California, Massachusetts, Montana, and Washington in offering coverage before release.
Stephanie Strong, CEO of Boulder Care, emphasized the importance of this policy, noting that individuals typically lose Medicaid benefits while incarcerated, and it takes weeks for coverage to be reinstated upon release. People with opioid use disorder often receive inadequate treatment during incarceration, putting them at a higher risk of overdose upon release. Strong pointed out that a gap in coverage can quickly turn into a major roadblock, particularly for those with life-threatening conditions like opioid use disorder.
Meghann Perry, founder of The Meghann Perry Group and an advocate with lived experience, called the HHS action a “logical step.” She highlighted the critical role continuous mental health and substance use services play in reducing recidivism and improving overall community wellbeing.
Hans Morefield, CEO of CHESS Health, also praised the HHS decision, stating that it should facilitate smoother transitions from prison treatment to community care, thereby enhancing reentry success and reducing recidivism rates.
Those who are incarcerated often suffer from higher rates of substance use disorder and chronic health conditions, exacerbated by poor healthcare coordination. Approximately 85% of people in prisons have an active substance use disorder or were incarcerated for drug-related crimes, according to the National Institute on Drug Abuse. Expanding access to treatment and recovery supports is seen as vital in the fight against the overdose epidemic.
The White House Office of National Drug Control Policy Director Dr. Rahul Gupta stated that this action provides a critical opportunity to increase access to healthcare for incarcerated individuals, particularly those with substance use disorders, and offers necessary tools for successful community reentry.
The Centers for Medicare & Medicaid Services (CMS) indicated that they are working with other states on similar Medicaid reentry demonstration requests.
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