Prison Health Director Points Working Group to Medicaid Expansion State Solutions for Former Inmates

Aug 21, 2019

Credit Oklahoma Watch

The Oklahoma Healthcare Working Group on Wednesday dug into the issue of prison health care and the sudden lack of care inmates face when they get out.

It’s rare for former inmates to have insurance, and few meet the eligibility requirements for Medicaid. Adults in Oklahoma must earn no more than 42% of the federal poverty level and be either 65 years old, blind, disabled, pregnant or caring for a child.

Inmates typically leave Oklahoma prisons with up to a 60-day supply of currently prescribed medications and either information about their health conditions or referrrals to health providers.

Oklahoma is also among a minority of states that terminates Medicaid benefits upon incarceration.

The lack of any health insurance leaves people recently released from prison two main choices: forego care or rely on emergency services, passing most of the costs on to the state.

Rep. Cynthia Roe said as a nurse, she saw more than one former inmate commit a new crime or violate parole after getting a diagnosis like cancer so they could go back to prison and get treatment.

"They’re not technically disabled. They’re not 65. Could some sort of expansion includes these inmates so they’re not deliberately violating their parole just to go to prison and get treatment?" Roe said.

Rep. Marcus McEntire asked Department of Corrections Health Services Director Clint Castleberry whether changing income requirements for Medicaid would help former inmates.

"If a state were to increase access to health care to 138% of the poverty level, it would capture a lot of these discharged people, is that correct?" McEntire said.

"Based on conversations I’ve had with my counterparts in other states, yes, at least for a period of time," Castleberry said.

Full Medicaid expansion extends eligibility to people making 138% of the federal poverty level.

Castleberry said Ohio found a fix for uninsured, recently released inmates after expanding Medicaid. They start the enrollment process months ahead of an inmate's release date so they have benefits the day they leave.

"Their department of health estimated upwards of $30 million in savings or cost offset just from a decrease in the number of individuals who had been corrections involved who would be accessing emergency room or other types of emergency services upon release," Castleberry said.

Castleberry said increasing Oklahoma's Medicaid income eligibility would cover most former inmates until they get back on their feet.

Castleberry also told the working group about New York's proposal, which would make inmates eligible for Medicaid reimbursement 30 days prior to release.