Former convicts who have left the prison population face particularly daunting challenges in America, including struggling to gain access to health care coverage. Due to the fact that ex-prisoners have a significantly higher unemployment rate than the average population, almost all male ex-prisoners struggle to obtain insurance through an employer. Obamacare can help change the high uninsurance rates among America’s former inmates — but only if states agree to participate in its Medicaid expansion.
Despite the fact that the health care reform law’s proposed expansion of the Medicaid program could help provide millions of low-income Americans with coverage they currently can’t afford, as many as half a dozen Republican governors are refusing to expand their Medicaid pools. Ex-prisoners living in such states will almost certainly be forced to pay for medical care out-of-pocket. On the other hand, stories out of the states that have begun to expand access to their Medicaid programs highlight the profound cost- and life-saving potential this Obamacare provision promises for ex-prisoners in particular.
California, which has the country’s second-largest inmate population behind Texas, initiated its Medicaid expansion late last year. According to an NPR report, the resulting decrease in poor adults’ uninsurance rates has been a boon to ex-cons who often move in and out of the prison system, providing them access to wellness initiatives, chronic illness treatments, and care for everday medical problems that often go untreated:
[Dr. George Pearson] says a 45-year-old ex-convict will often have the ailments of someone 10 years older. Ex-convicts have higher rates of almost all chronic conditions, like high blood pressure, diabetes and asthma. It’s from living a hard life, to be sure, he says, but it’s also because they have common medical problems that go untreated.
“So the hypertension becomes heart failure, the diabetes becomes diabetic neuropathy, amputation, blindness,” Pearson says.
Now, many of those getting out of prison and other poor adults in California are being enrolled in a Medicaid-like program where they will be covered for preventive care, prescription drugs, specialty visits, mental health and substance abuse — pervasive problems that when left untreated, researchers say, can lead offenders right back to prison or jail.
Washington, D.C. has seen similarly positive results with former prisoners since opening up its Medicaid program. As Dr. Ilse Levin of southeast D.C. explains, “Now, everyone gets Medicaid. And suddenly I can get them their medications, I can get them to see a specialist, I can get the studies done. And it is amazing. It’s completely changed my practice.”
State experiences such as these underscore the significant difference that Obamacare’s Medicaid expansion makes in the lives of America’s most vulnerable populations. If Republican governors and state legislatures continue their political crusade against the expansion, it will be at the cost of helping those who need it most.