Following a 2018 law, 27 states have sought or received federal approval to provide certain services under Medicaid to individuals up to 90 days prior to release from incarceration and after.

Reminder: Historically, Medicaid has excluded incarcerated people from coverage. A person with Medicaid coverage would typically lose it upon incarceration and then need to reenroll upon their release.

Why it’s important:

The process of reenrolling could take months, creating a dangerous gap in services for incarcerated people, many of whom have chronic conditions, substance use disorder (SUD), and/or serious mental illness. This contributes to the high risk for overdose and other deaths following release from incarceration.
The waivers allowing connections to some Medicaid services are a critical shift that provides significant benefits for incarcerated people’s health and safety and for the communities they reenter.

The numbers: Six states have begun offering reentry services through Medicaid so far. Another 12 have had their waivers approved, and 8 others and DC have filed plans that have not yet been approved.

But: The expansion of these services has been complicated by the changes to Medicaid enacted over the summer in the reconciliation law.

Work requirements for Medicaid go into effect next year. States can exempt people who were recently released from incarceration or who have certain medical conditions, including SUD, but how that works in practice will depend on yet-to-be-published federal guidance.
Oregon’s Medicaid program had received approval for its reentry services waiver but withdrew in October, citing a lack of bandwidth to address competing priorities compelled by the federal legislation.