No Panacea, but Obamacare Could Help Reduce Prison Population, Report Says

Even before the presidential election secured the full implementation of the Affordable Care Act (ACA), commonly referred to as "Obamacare,” many prisoner advocates were championing the law as both a boon for the national prison population and a partial cure for over-incarceration. A September 2012 report from the Sentencing Project, based in Washington, D.C., explains how.

Overall, offenders are more likely than the general population to have mental health issues, including addictions, communicable diseases like hepatitis-C and HIV, and chronic illnesses, such as diabetes and hypertension. And they're far less likely to be treated.

Having lived in poor socioeconomic conditions, most of the approximately 10 million offenders who spend time in jails and prisons every year have little access to much-needed medical and behavioral care prior to incarceration. In fact, according to the Sentencing Project, as much as 75% of men booked in 2010 into jails in major cities surveyed didn't have health insurance. About half of all people incarcerated have mental health problems, while 65% "meet medical criteria," according to the report, for alcohol or drug abuse and addiction.

With Obamacare, those numbers could potentially decline.

By 2014, every state will be required to operate a regulated health insurance exchange, whereby the uninsured with incomes between 133% and 400% of the federal poverty level can purchase coverage and receive tax credits to offset the costs. In states that choose to expand their Medicaid coverage, also in 2014, to all people under age 65—with 100% of the costs for the newly eligible covered by the Federal government until 2016 (and 90% of the costs after 2020)—the Sentencing Project expects that "many people at risk for being incarcerated and many who will be released from correctional facilities" will represent a significant portion of those covered under the ACA.

"The expansion of Medicaid means that states can essentially use federal Medicaid funds to increase treatment services that could reduce incarceration and recidivism," the report said. "And. in doing so, potentially lower associated local and state corrections expenditures."

Nobody is claiming that Obamacare will eradicate crime: people will still be incarcerated. And counties and states will still be forbidden from using federal Medicaid funds on those in jails and prisons. But the Sentencing Project believes that greater access to healthcare for offenders prior to incarceration will reduce the burden on correctional medical and mental health resources, thereby improving overall care for prisoners.

The Sentencing Project also contends that the ACA will help "reduce racial disparities in incarceration related to disparities in health care access." According to the report, African-Americans and other minorities suffer serious health problems and certain mental illnesses at higher rates than whites, largely because of the same societal issues—higher rates of poverty, lower socioeconomic status, stress from discrimination—that have caused racial disparities in incarceration rates.

The ACA, according to the Sentencing Project, poses an opportunity to increase access to treatment for mental illness and addiction, "two problems that increase the likelihood of arrest and recidivism."

"In doing so." the report concluded, "it may help reduce racial/ethnic disparities in incarceration." Source: The Sentencing Project. "The Affordable Care Act: Implications for Public Safety and Corrections Populations." September 2012: www.sentencingproject.org

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