How to Apply Obamacare to Keep People Out of Prison

The expansion of Medicaid in 2014 could help lower the crime rate, advocates say.

Between one-third and three-quarters of men booked into urban jails in 2010 didn’t have any health insurance (Photo: David McNew/Getty).

Sep 14, 2012· 2 MIN READ
is a Los Angeles-based writer whose work has appeared Atlantic, Back Stage, The Christian Science Monitor and The Hill.

The Patient Protection and Affordable Care Act, also known as Obamacare, may have an unintended consequence when many of its provisions are implemented in 2014.

The healthcare act has the potential to decrease crime, some advocates say.

The population most at risk for becoming part of America’s prison demographic is either unemployed or stuck in low-wage jobs that frequently have no health benefits or sick leave and high turnover. Getting sick, with limited or no avenue to medical attention, can mean joining the long-term unemployed, leading to disillusionment, desperation and criminal behavior.

Moreover, inmates coming out of prison often lose the state-provided care they were receiving on the inside. Without access to needed health and, especially, behavioral care services, advocates say that former inmates are more likely to return to crime.

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“I wouldn’t want to promise dramatic changes,” says Marc Mauer, executive director of the Sentencing Project, a Washington-based advocacy group, discussing the use of Obamacare to battle recidivism. “But it’s likely we could see at least modest reductions in criminal activity and recidivism. It’s likely to push things in a better direction.”

Take this statistic: Between one-third and three-quarters of men booked into urban jails in 2010 didn’t have any health insurance. That’s according to a 2011 study by the Office of National Drug Control Policy.

To make matters worse, those behind bars are more likely than those in the general population to have addictions or mental health issues, communicable diseases such as tuberculosis, Hepatitis C, or HIV, and chronic illnesses such as diabetes, asthma and hypertension, according to a report by Mauer’s group, the Sentencing Project.

Mental health and substance abuse treatment are crucial to warding off old behaviors that can result in recidivism.

With roughly 700,000 ex-cons hitting the streets each year, the demand for medical services is great.

So how can the PPACA help?

By 2014 each state must have a health insurance exchange that could help lower the cost of buying insurance directly, and individuals will receive tax credits to offset the cost. Perhaps more important for recently released prisoners, states will also have the option to expand Medicaid coverage to all individuals under age 65 with incomes below 133 percent of the federal poverty level. That coverage will include mental health and substance abuse treatment—crucial care to ward off old behaviors that can result in recidivism.

“The expansion of Medicaid means that states can essentially use federal Medicaid funds to increase treatment services that could reduce incarceration and recidivism and, in doing so, potentially lower associated local and state corrections expenditures,” states a report recently released by the Sentencing Project.

Here’s the catch. The federal government, to help states implement the expansion, will cover 100 percent of the cost—but only through 2016. After that, the feds’ contribution declines to 90 percent by 2020.

That need for states to kick in money has made some governors hostile to the PPACA. Florida Governor Rick Scott (R) has said his state will opt out of the expansion. Georgia Governor Nathan Deal (R) has also opposed the expansion of the program, as has Texas Governor Rick Perry (R).

That could be bad news for released prisoners and those at risk of incarceration: Those states have some of the largest prison populations in the country. Texas, for instance, has the dubious distinction of being home to the largest state prison system in the country, and Florida ranks number three.

“It should be a no brainer to take advantage of [the PPACA],” says the Sentencing Project’s Mauer.

Will access to adequate medical care reduce crime rates or just produce healthier criminals? Leave your diagnosis in COMMENTS.