Oregon’s New Medicaid Program for InmatesOregon’s New Medicaid Program for Inmates Federal officials have granted Oregon’s request to provide free Medicaid services to inmates nearing release from prison. This program aims to address the gap in healthcare faced by individuals transitioning from incarceration to the community. Benefits of the Program The program will provide inmates with Medicaid coverage for laboratory and radiology services, mental health evaluations, and medications for opioid addiction and mental illness. Inmates will receive these services 90 days before their release, ensuring a seamless transition to healthcare upon reentry. Addressing Healthcare Disparities Studies have shown that inmates have higher rates of physical and mental illnesses compared to the general population. By providing healthcare services before release, the program aims to identify and address these disparities. Rehabilitation and Reentry The program’s goal is to provide a comprehensive approach to rehabilitation and reentry. By connecting inmates with healthcare services while incarcerated, it is expected to facilitate their access to counseling and treatment upon release. Legislative Support Oregon’s Legislature passed House Bill 4002, which provided $211 million to address addiction and $10 million to screen and treat inmates for opioid addiction. These funds will support the implementation of the Medicaid program. National Efforts The Medicaid program is part of the Biden administration’s efforts to address the nation’s addiction crisis. By expanding access to treatment and recovery support for prisoners, the program aims to combat the overdose epidemic. Timeline and Implementation The program is set to launch in 2026. The Oregon Health Authority will work with prison facilities to assess their readiness and provide support for implementation. The program is expected to benefit thousands of individuals in Oregon.
Federal officials have approved Oregon’s request to offer free Medicaid addiction services and some other services to people about to be released from prison, a practice prohibited by federal law.
The U.S. Department of Health and Human Services said Oregon will offer the new program, along with Illinois, Kentucky, Utah and Vermont. They join California, Massachusetts, Montana and Washington state, which were the first to pilot programs to offer Medicaid services to people about to be released from prison.
Inmates who meet Medicaid’s low-income eligibility requirements are eligible for the program 90 days before their release from prison or state or tribal jail. They are eligible for laboratory and radiology services, along with mental health evaluations and medications to treat opioid addiction and mental illness.
When people are incarcerated, they lose their Medicaid coverage and must reapply when they are released. That leads to gaps in health care. Studies show that people who end up in prison or jail have higher rates than the general public of physical and mental illnesses, including hypertension, asthma, tuberculosis, hepatitis B and C, and HIV, and higher rates of premature death from infectious and chronic diseases, substance abuse, and suicide.
“For people involved in the justice system, ensuring their successful reentry into society means ensuring they receive the health care and services they need,” Health and Human Services Secretary Xavier Becerra said in a statement.
The program is aimed at providing a seamless transition to health care as people try to rebuild their lives in the community. Being screened for mental health issues while still incarcerated is expected to help them get counseling or other treatment more quickly when they are released.
“Fifty percent of all people in Oregon prisons have a diagnosis of a disability or mental illness, making uninterrupted care very important,” said Amy Bacher, spokeswoman for the Oregon Health Authority, in a statement.
People who participate benefit from case management, which means they are assessed before release and monitored once they are out. State officials hope that people will be able to enroll in a regionally based Medicaid provider, a coordinated care organization, once they are released, something that has been a challenge in the past.
Capt. Lee Eby, jail commander with the Clackamas County Sheriff’s Office, said the program is a “gigantic step” toward rehabilitating people in the community.
“I have seen the effects of our current system, where the gaps we experience prevent much-needed access to care and services for those leaving prison to continue on their path to recovery,” Eby said. “This funding will be a tremendous resource for prisons to help those who are incarcerated receive proper discharge planning for successful reentry into society, and to ensure continued care for one of our most vulnerable populations.”
Lawmakers tackle problem
The program’s approval follows the Oregon Legislature’s passage of House Bill 4002. The bill provides $211 million to address addiction, including creating new diversion programs for people accused of possessing small amounts of illegal substances. It also includes $10 million to screen people in prison for opioid addiction and treat them with medication so they can stabilize their lives and continue their recovery upon release.
About 65 percent of people behind bars have a substance abuse problem, according to the Centers for Medicare and Medicaid Services, but they often aren’t screened or treated. This $10 million allocation — and the just-passed Medicaid program — are intended to address that problem. Democratic Rep. Pam Marsh of Ashland, who led the push in the Legislature to offer drug treatment for opioid use disorder in prison, welcomed the program’s passage.
“I am pleased with the approval of the Medicaid waiver, which provides long-term sustainability to continue and expand opioid medication treatment in our prisons,” Marsh told the Capital Chronicle. “These services are critical if we are to break the cycle of addiction, crime and incarceration — and save lives in the process.”
Opioid overdoses have skyrocketed in Oregon in recent years due to the proliferation of fentanyl, which can be deadly in small doses and is mixed into counterfeit opioid pills sold on the street for as little as a dollar. According to the Oregon Health Authority, 280 people in Oregon died from fatal opioid overdoses in 2019. That number rose to about 1,050 in 2023.
The Medicaid program is an effort by the Biden administration to address the nation’s addiction crisis.
“Expanding access to lifesaving treatment and recovery support for prisoners is a critical part of our bipartisan efforts to defeat the overdose epidemic and save lives,” Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, said in a statement.
The Centers for Medicare and Medicaid Services said thousands of people would benefit from the newly approved programs in the five states, but it’s unclear how many people will qualify in Oregon. Bacher of the Oregon Health Authority said 60 facilities with more than 20,000 beds are eligible for the program, but they must apply.
“We will work closely with partners in the prison system to assess their readiness and support their ability to implement if the institution and their local partners choose to do so,” Bacher said.
The cost is unclear, but the largest portion comes from the federal coffers. The federal government pays about 60 percent of Medicaid, while the state pays the rest.
The health authority aims to launch the program in 2026
“We will be working on implementation timetables and will be working extensively with prisons to be prepared for this,” Bacher said in the statement.
by Lynne Terry, Oregon Capital Chronicle
