A Beginner’s Guide to Medicaid and Incarceration in Missouri

Medicaid can be confusing. It doesn’t matter who we’re talking to: when Missouri Appleseed brings up Medicaid, most people have questions. It gets even more confusing in the context of Medicaid and incarceration because Medicaid cannot always cover services for incarcerated individuals. In this post, we discuss Medicaid services, who can get Medicaid in jail or prison, and why Medicaid is so important for people involved in the criminal justice system.

What is Medicaid?

Medicaid is a key piece of the safety net that provides low- to no-cost health insurance for lower-income Missourians. Medicaid can cover adults, children, pregnant women, elderly adults and people with disabilities. (Here is a good calculator to see if you or your family qualify!)

Medicaid pays for people to see a doctor when they are sick. But it also pays for regular check-ups, medications, hospital stays, and care from dentists, eye doctors, and mental health professionals.

Medicaid is a federal-state partnership. The federal government created Medicaid, makes many of the rules for Medicaid, and pays for much of the program. However, states administer Medicaid, which means that states get to create their own guidelines and must also pay for some of the cost of the program. In Missouri, our Medicaid program is called MO HealthNet. Applying to MO HealthNet is free and usually takes about half an hour.

Good to know: Medicaid is not the same as Medicare. Medicare is a similar government-supported health insurance but only for people who are aged 65 or older.

Can people in jail or prison get Medicaid?

People in jail or prison can get Medicaid! However, there are a few laws that govern when and how incarcerated people can enroll in Medicaid.

The Medicaid Exclusion Policy of the Social Security Act

When Medicaid was first created by the Social Security Act, this Act also included language that prevented Medicaid from being used by incarcerated people for healthcare received while in jail or prison – that is, in most cases.

This policy ensures that Medicaid funds are not used for healthcare services already provided within correctional facilities. Incarcerated individuals typically rely on healthcare services provided by the facility where they are detained, funded separately from Medicaid.

However, Medicaid is still useful in certain situations. Correctional and detentional facilities can bill Medicaid for any services an incarcerated person receives if they are outside the facility for more than 24 hours (if the person is already enrolled in Medicaid). This means, for example, that Medicaid can kick in for a person with appendicitis if they spend more than one day in the hospital.

Missouri Senate Bill 514: Medicaid Suspension Upon Incarceration

Before 2019, when a person entered incarceration in Missouri, if they had Medicaid, the state immediately terminated it. Thankfully, in 2019 the Missouri Senate passed Senate Bill 514 changing the Medicaid status of incarcerated individuals from “terminated” to “suspended”.

This change allows incarcerated individuals to apply for Medicaid while incarcerated. If enrolled, the state suspends Medicaid coverage for the duration of their incarceration and reactivates it upon release so that they can access treatment and essential medications.

Missouri Medicaid Expansion

Missouri “expanded” Medicaid in 2020 by ballot initiative (that is, by popular vote). The “expansion” was of the group of people eligible for Medicaid: before expansion, only the very lowest income could qualify a person for Missouri Medicaid (maxing out at $4,000 in annual income for a single person). Expanding eligibility means that many, many more Missourians now qualify for Medicaid (up to almost $20,000 in annual income for a single person).

People in jails and prisons are more likely to be lower income, so Medicaid expansion made a large number of incarcerated Missourians eligible for Medicaid for the first time.

What’s the big deal about Medicaid for incarcerated folks?

Research shows that people leaving incarceration with health insurance are less likely to return to jail or prison. Having Medicaid upon leaving jail or prison helps connect a person to much-needed continued care, so they don’t have to wait weeks for new prescriptions or to see a doctor. Having healthcare upon release also reduces the need for expensive Emergency Room visits.

Read more about our work in Missouri jails to bring Medicaid enrollment to all incarcerated Missourians.

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Wilford Pinkney Jr.

St. Louis Mayor’s Office

City of St. Louis, Office of Violence Prevention

Wilford Pinkney Jr. currently serves as the Director of the Office of Violence Prevention for the City of St. Louis. The Office of Violence Prevention provides strategic direction and oversight for the City of St. Louis’ efforts to create safe and healthy neighborhoods free of violence.

Mr. Pinkney previously served as the Director of the Mayor’s Office of Children, Youth, and Families for the City of St. Louis. He has overseen the development of a Crisis Management System focused on building healthy and vibrant communities by addressing trauma and increasing access to care. Prior to joining the administration, Pinkney was a FUSE Executive Fellow leading a cross-sector group of stakeholders in the development of a comprehensive pretrial reform plan in the City of St. Louis.

Wilford holds a B.S. in Organizational Management from Mercy College, a Masters in Public Administration from New York University, and a Master of Arts in Political Science from the CUNY Graduate Center. He is currently a doctoral candidate in Political Science at the CUNY Graduate Center, where he specializes in public policy and American politics.

Wilford Pinkney Jr.

St. Louis Mayor’s Office

City of St. Louis, Office of Violence Prevention

Wilford Pinkney Jr. currently serves as the Director of the Office of Violence Prevention for the City of St. Louis. The Office of Violence Prevention provides strategic direction and oversight for the City of St. Louis’ efforts to create safe and healthy neighborhoods free of violence.

Mr. Pinkney previously served as the Director of the Mayor’s Office of Children, Youth, and Families for the City of St. Louis. He has overseen the development of a Crisis Management System focused on building healthy and vibrant communities by addressing trauma and increasing access to care. Prior to joining the administration, Pinkney was a FUSE Executive Fellow leading a cross-sector group of stakeholders in the development of a comprehensive pretrial reform plan in the City of St. Louis.

Wilford holds a B.S. in Organizational Management from Mercy College, a Masters in Public Administration from New York University, and a Master of Arts in Political Science from the CUNY Graduate Center. He is currently a doctoral candidate in Political Science at the CUNY Graduate Center, where he specializes in public policy and American politics.

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Todd Kaye

Board President

Bryan Cave Leighton Paisner LLP

A partner at Bryan Cave Leighton Paisner, where he focuses on mergers and acquisitions, securities law, and general corporate matters, Mr. Kaye holds a J.D. and an M.B.A. from Washington University in St. Louis. He also serves on the Board of Directors of College Bound. Mr. Kaye has been a member of Missouri Appleseed’s Board of Directors since November 2017.

Anisha Moorhead

Board Vice President

Lindenwood University

Ms. Moorhead received her B.A. in Interdisciplinary Studies from the University of Missouri – Columbia. She holds an M.B.A. in Marketing and an M.A. in Corporate Communication in Promotions from Lindenwood University. She is the former Director of Communications and Annual Programs for SSM Health Care – St. Louis, a former Lambert St. Louis Airport Commissioner and Forest Park Advisory Board Member, and a member of the 2011-2012 class of Leadership St. Louis. She is currently a Ph.D. candidate in Educational Leadership and Policy Analysis with an emphasis in Critical Race Theory at University of Missouri – St. Louis and an Adjunct Professor of Communications at Lindenwood University. Ms. Moorhead has been a member of Missouri Appleseed’s Board of Directors since November 2017.

Hugh A. Eastwood

Board Secretary

Attorney at Law

Mr. Eastwood is a litigator, mostly in civil rights, who has won significant verdicts and settlements for victims of government misconduct, for whistleblowers, and for those harmed by breach of trust and contract. He received his B.A. and J.D. from Yale, where he has also taught. Before law school, he managed the site design competition for the rebuilding of the World Trade Center at Ground Zero. Mr. Eastwood serves on the boards of several St. Louis nonprofits and has been a director of Missouri Appleseed since November 2017.

Molly Carney

Board Treasurer

Staff Attorney, ACLU of Missouri

Ms. Carney is a staff attorney at ACLU of Missouri. Before that, she served as in-house counsel at Wells Fargo Advisors, where she supported the brokerage business with a variety of legal matters. Previously, Ms. Carney clerked for Chief Judge Rodney Sippel of the United States District Court for the Eastern District of Missouri and spent several years practicing trusts and estates law. She is a graduate of Northwestern University and Washington University in St. Louis School of Law. She has been a member of Missouri Appleseed’s Board of Directors since April 2019.

Andrew Schlichter

Board Nominations and Governance

Schlichter Bogard & Denton

Mr. Schlichter is a trial attorney at Schlichter Bogard & Denton, where he focuses on class actions and complex civil litigation. He received his B.A. from Georgetown University and J.D. from the University of Michigan Law School and has been a member of Missouri Appleseed’s Board of Directors since November 2017.

Brandon Hall

Armstrong Teasdale, LLP

Mr. Hall is an associate attorney at Armstrong Teasdale, LLP, where he practices corporate and health care law. He obtained his B.A. in Political Science and Public Policy from the Rockefeller College of Public Affairs & Policy at SUNY Albany and his J.D. with concentrations in both health and employment law from St. Louis University School of Law. Prior to and during law school, Mr. Hall worked extensively in government relations, including on state and federal health policy issues.

Cindy Finney Henry

Attorney at Law

Ms. Henry earned her B.A. in Justice Systems from Truman State University and her J.D. from St. Louis University. She spent nearly two years as an Assistant Circuit Attorney in St. Louis City, where she prosecuted cases ranging from misdemeanors to sex crimes and child abuse. Ms. Henry then spent several years representing juveniles in delinquency and criminal proceedings as part of the Missouri Public Defender’s Juvenile Defense Unit. Most recently Ms. Henry taught several courses as an adjunct professor in the Criminal Justice Program at St. Louis Community College. Ms. Henry has been a member of Missouri Appleseed’s Board of Directors since November 2017.

Tali Katz

Greensfelder, Hemker & Gale, P.C.

Mrs. Katz is an attorney at Greensfelder, Hemker & Gale, P.C. She practices litigation with a focus on corporate defense work. She previously worked for the Office of the District Attorney General in Nashville, Tennessee, where she led the domestic violence prosecution team. In 2014, Mrs. Katz received the Outstanding State Government Official award for her work as a prosecutor. Mrs. Katz served as a director of The Mary Parrish Center for victims of domestic and sexual violence in Nashville and has been a director of Missouri Appleseed since January 2018.

Ray Lin

Mohegan Gaming & Entertainment

Mr. Lin received his B.A. from Harvard University and his J.D. from Columbia University. He is Chief Legal Officer for Mohegan Gaming & Entertainment. He is a retired partner at Latham & Watkins LLP, where his practice focused on the representation of private equity firms in mergers and acquisitions and capital market transactions. He serves on the Board of Visitors of Columbia Law School. Mr. Lin is Chairman of National Appleseed’s Board of Directors and has been a member of Missouri Appleseed’s Board of Directors since November 2017.

Jessica Moore

Head of Enterprise Strategy

Arianna Muckerman

The Centene Corporation

Arianna Muckerman is the for the Centene Corporation. She received her B.A. from Boston College and her M.P.H. from Washington University in St. Louis. She has been a member of Missouri Appleseed’s Board of Directors since July 2021.

Wilford Pinkney Jr.

St. Louis Mayor’s Office

City of St. Louis, Office of Violence Prevention

Wilford Pinkney Jr. currently serves as the Director of the Office of Violence Prevention for the City of St. Louis. The Office of Violence Prevention provides strategic direction and oversight for the City of St. Louis’ efforts to create safe and healthy neighborhoods free of violence.

Mr. Pinkney previously served as the Director of the Mayor’s Office of Children, Youth, and Families for the City of St. Louis. He has overseen the development of a Crisis Management System focused on building healthy and vibrant communities by addressing trauma and increasing access to care. Prior to joining the administration, Pinkney was a FUSE Executive Fellow leading a cross-sector group of stakeholders in the development of a comprehensive pretrial reform plan in the City of St. Louis.

Wilford holds a B.S. in Organizational Management from Mercy College, a Masters in Public Administration from New York University, and a Master of Arts in Political Science from the CUNY Graduate Center. He is currently a doctoral candidate in Political Science at the CUNY Graduate Center, where he specializes in public policy and American politics.

Alexandra Rankin

Upstream USA

Alex Rankin is the Associate Director of State Policy with Upstream USA and has worked to advance access to health care throughout her career. Prior to joining Upstream, Alex worked as the Director of Government Affairs for a large health foundation where she was responsible for engaging and educating policymakers on various health policy topics, including Medicaid and maternal and reproductive health. Alex graduated from Saint Louis University School of Law in 2015 with a concentration in health law and is a licensed attorney through the Missouri Bar. Alex lives in St. Louis with her husband, daughter, and dog and enjoys exploring new parks and the vibrant St. Louis foodie scene.

Missouri Appleseed green

Annie Beattie

St. Louis County Justice Services

Ms. Beattie is a staff attorney for the St. Louis County Justice Services Pre-Trial Release Program. She received her B.A. from the University of Virginia and her J.D. from Georgia State University College of Law. Ms. Beattie, who also serves on the founding Board of Directors of Gateway Children’s Charity, has been a member of Missouri Appleseed’s Board of Directors since November 2017.

Michelle Clardy Dobbs

Caleres, Inc.

Associate General Counsel

Missouri Appleseed - Liza Weiss

Liza Weiss

Founding Director

Liza Weiss is the Executive Director of Missouri Appleseed. Liza is a St. Louis native and former public interest attorney. She holds a B.A. from Yale University and a J.D. from George Washington University Law School. Liza’s professional background includes work with the Neighborhood Defender Service of Harlem, the Committee for Public Counsel Services, and the Children’s Law Center (DC).

Julie Alverson

US Account Director, Health and Beauty at Brand Addition

Emily Baron Bernstein

McCormack Baron Salazar

As Senior Vice President of Development at McCormack Baron Salazar, Ms. Bernstein is responsible for all aspects of the development process, including leveraging and securing project financing and coordinating a diverse team of specialists, consultants, investors, stakeholders, and public officials from project inception through project stabilization.

She has worked on multiple development projects, including North Sarah Apartments, Flance Early Learning Center, Covenant Place, and Preservation Square in St. Louis, Foote Park at South City in Memphis, Tenn., and the Cedars and Magnolia in Galveston, Texas.

Prior to joining McCormack Baron Salazar, Ms. Bernstein worked at the Nathalie P. Voorhees Center for Neighborhoods and Community Improvement and the Community Development Financial Institution, IFF, in their Real Estate Development Group. Ms. Bernstein’s experience extends beyond managing development and construction into financial structuring of both 9% and 4% low-income housing tax credit deals, as well as mixed finance transactions.

Ms. Bernstein holds a Master of Arts in Urban Planning from the University of Illinois at Chicago and a Bachelor of Arts in Urban Studies from the University of Pennsylvania.

Jake Rosenfeld

The Weidenbaum Center

Jake Rosenfeld is a professor of sociology at Washington University in St. Louis, and a resident fellow of the Weidenbaum Center on the Economy, Government, and Public Policy. He is primarily interested in the determinants of wages and salaries, and how these vary across time and place. His book What Unions No Longer Do (Harvard University Press 2014) examines the consequences of organized labor’s decline, and received wide attention in such outlets as the New Yorker and Harvard Business Review. His book You’re Paid What You’re Worth and Other Myths of the Modern Economy (Harvard University Press 2021) seeks to answer the basic question: who gets what and why? The book has been featured in the Wall Street Journal, Washington Post, and Harvard Business Review, among other outlets. He received his Ph.D. from Princeton University.

Mary Quandt

Mary Quandt

Director of Public Health Policy

Mary Quandt is the Director of Public Health Policy at Missouri Appleseed. Originally from rural Wisconsin, she has called Missouri home for almost a decade. Mary received her bachelor’s degree from the University of Wisconsin-Madison, a Master of Public Health from Washington University in St. Louis, and a law degree from St. Louis University School of Law. Before Missouri Appleseed, Mary served in the Peace Corps as a health educator and worked with various public health nonprofits.

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