Imagine a scenario where incarcerated individuals are granted access to essential substance abuse treatment — a ray of hope during a time of hopelessness for many seeking help. This is made possible by a pioneering initiative that champions a fresh perspective on mental health.
Health care — and in particular, mental health care — is fundamental for individuals leaving incarceration, not only in addressing immediate medical needs, but also in significantly improving chances of successful reentry into society.
The Medicaid Reentry Section 1115 Demonstration Opportunity is a federal initiative that permits states to use Medicaid to provide health care to individuals 90 days before they are released from jail or prison. The 1115 Reentry Opportunity allows state Medicaid programs to cover services that address various health concerns such as substance use disorders and other chronic health conditions. Missouri has applied for a waiver under the program.
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Historically, incarcerated individuals faced significant barriers to accessing health care services upon release, leading to increased risks of relapse, recidivism, and overall poor health outcomes.
However, with the introduction of the 1115 Reentry Opportunity, states like Missouri have the opportunity to bridge this gap and ensure that individuals leaving incarceration have access to the necessary medical and behavioral health services to support their successful reintegration into society.
Health care plays a crucial role in successful reentry post-incarceration by addressing the unique needs of individuals transitioning back into society. Access to health care ensures proper treatment for physical and mental health conditions, reducing the risk of people return to incarceration after release. Improved health also enhances employability, stability, and community integration, creating safer communities.
While the creation of this waiver opportunity is an exciting step forward for health care, the path to realization in Missouri will require substantial time and effort from the state. Applying for a Medicaid waiver can take states years of work.
Since the establishment of Medicaid, the program has never extended coverage to individuals classified as “inmates of a public institution,” as federal regulations prohibit federal funding for such services. Consequently, incarcerated individuals are unable to access Medicaid-funded services and resources, potentially encountering delays in obtaining them upon release.
Moreover, individuals with disabilities, as well as those from Black, Native American, and Hispanic communities, are disproportionately represented in correctional facilities. Thus, it is imperative to enroll individuals in carceral settings in Medicaid and facilitate their connection with services upon release to mitigate health disparities and promote health equity.
The 1115 Reentry Opportunity introduces key features aimed at transforming the health care landscape within the criminal justice system.
First, incarcerated individuals will be able to benefit from pre-release services, gaining access to crucial substance use treatment and ensuring access to health care providers immediately upon release. This not only promotes individual well-being, but also fosters rehabilitation and reduces recidivism.
Second, states like Arkansas have applied for the 1115 Reentry Opportunity with an emphasis on providing obstetrics, primary care, and behavioral health care. Arkansas has prioritized maternal health to promote healthy mothers and children. Improving access to prenatal and postnatal care can lead to healthier outcomes for mothers and their babies, potentially reducing health care costs in the long term.
Third, the 1115 Reentry Opportunity prioritizes the quality of care for incarcerated individuals and emphasizes a reentry focus. The primary objectives revolve around not only improving the health care provided to those within the justice system, but also ensuring a smooth transition and reintegration into their communities after release.
By extending support beyond the prison and jail walls, these initiatives will have a ripple effect, benefiting broader communities as well. Improved access to substance abuse treatment and mental health services for individuals reentering society can lead to lower crime rates, safer neighborhoods, and stronger families — a win-win situation that resonates with all Missourians.
The 1115 Reentry Opportunity holds immense promise in transforming the health care landscape within the criminal justice system, offering a beacon of hope for individuals seeking to rebuild their lives post-incarceration. As states like Missouri embark on the journey to implement this initiative, it is crucial to recognize that the path to meaningful change will require sustained commitment, collaboration, and investment in evidence-based solutions.
By prioritizing the holistic well-being of justice-involved individuals and fostering a supportive environment for their reintegration into society, we can not only reduce recidivism rates but also build safer, healthier communities for all.
As we move forward, let us remain steadfast in our efforts to uphold the principles of justice, compassion, and equity, ensuring that every individual has the opportunity to thrive and contribute positively to society.
Phan is a third-year law student at Saint Louis University School of Law.
