New Opportunities to Improve Health Care Access for People Leaving Incarceration

Table of Contents

• New Opportunities to Improve Health Care Access for People Leaving Incarceration 1
• Making It Easier to Get Insurance and Transition Care Upon Release 1
• An important facet of successful reentry, particularly for people living with chronic health conditions, is access to health coverage and care upon release. The relatively low incomes of most people impacted by incarceration mean that a large percenta... 1
• Table 1: Medicaid Reentry Legislation 1
• Impact on Medicaid 1
• Provision 1
• Currently, when an adult Medicaid enrollee is incarcerated, a state can either suspend their Medicaid benefits or terminate coverage completely, meaning that the person will have to submit a new application for enrollment when they are released. The CAA of 2024 requires states to suspend rather than terminate Medicaid for all Medicaid beneficiaries who are incarcerated starting in 2026 and provides capacity building funds for states to prepare systems for this change. Many states had already been doing this, but the CAA makes the policy mandatory. 1
• Consolidated Appropriations Act of 2024 1
• Requires states to cover case management and some diagnostic and screening services for youth prior to and immediately following release. Allows states to provide Medicaid services to youth who are incarcerated pending disposition of charges. This policy will take effect beginning in 2025. 2
• Consolidated Appropriations Act of 2023 2
• Directs CMS to issue guidance on Section 1115 waivers for prerelease coverage of people leaving incarceration. CMS issued this guidance in April 2023, as discussed in our previous Health Care in Motion on reentry. 2
• The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) of 2018 2
• The SUPPORT Act also prohibited suspension rather than termination of coverage for incarcerated youth. 2
• For more details on the above policies, including when to expect additional guidance from the Administration, see the Health and Reentry Project’s Fact Sheet: Medicaid’s New Role in Advancing Reentry: Key Policy Changes. 2
• In addition to policies that ease transitions to Medicaid, the Administration has announced other policies aimed at helping people leaving incarceration more easily access Medicare and Marketplace plans through the availability of Special Enrollment P... 2
•  For Medicare, there is now an SEP for formerly incarcerated people who did not enroll in Premium Part A or Part B because they were incarcerated. The SEP begins on the day the person is released from incarceration and the SEP ends the last day of th... 2
•  For Marketplace coverage, people leaving incarceration have been covered under the longstanding SEP for a permanent move, which allows someone newly released from incarceration to enroll in Marketplace coverage in the 60 days following release. Thou... 2
• Meeting the Health-Related Social Needs of People Leaving Incarceration 3
• Improving the health outcomes of people leaving incarceration will also require strategies to better meet the health-related social needs of these individuals, who are often released without secure and stable access to housing, income, transportation,... 3
• What’s Next? 3
• The federal initiatives discussed above are important steps to addressing the health care, social services, and public health needs of people leaving incarceration settings. However, the impact of these initiatives will largely depend on how effective... 3