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.