Advocacy Alert: Letter to Show Support for the Reentry Act

April 13, 2023

The National Behavioral Health Association of Providers is endorsing the Reentry Act, otherwise known as HR 2400.

This critical legislation would allow incarcerated individuals to receive medical services supported by Medicaid thirty days prior to the individual’s release.

Currently, the Medicaid inmate exclusion policy prohibits the use of federal funds and services for medical care for "inmates of a public institution." This policy prevents Medicaid-eligible incarcerated individuals from receiving services funded by Medicaid. The policy also prevents incarcerated veterans from receiving hospital and outpatient care in local jails from the Department of Veterans Affairs.

The Medicaid inmate exclusion policy was established in Sec. 1905(a)(A) of the Social Security Act, decades before the current overdose crisis began. Almost sixty years later, the Medicaid inmate exclusion policy has become a significant barrier to accessing substance use disorder treatment in correctional facilities. Despite nearly 60% of incarcerated individuals having a substance use disorder, most go untreated. In 2021, just 12% of jails and prisons offered medications for opioid use disorder (MOUD). According to the New England Journal of Medicine, individuals reentering the community from incarcerations are 129 times more likely to die of a drug overdose during the two weeks following their release than the general population. Restarting a person's Medicaid coverage prior to release would enable jails and prisons to initiate and stabilize individuals on medications for opioid use disorder (MOUD), such as buprenorphine and methadone, prior to release. These FDA-approved medications have been associated with an 80% reduction in overdose mortality risk for the first month post-release. Despite its effectiveness, most jails and prisons do not provide methadone or buprenorphine for opioid use disorders.

The Medicaid inmate exclusion policy has also negatively impacted public safety and our nation’s recidivism rates. When treatment is unavailable in a correctional setting or there is not a plan to ensure continuity for care after release, the likelihood of an individual reoffending increases. Research has shown that providing buprenorphine not only reduces mortality rates among former inmates with an opioid use disorder but also can lead to a 32% reduction in recidivism rates.

"The re-entry act has been a high priority of our community for quite some time," says Pete Nielsen, CEO of NBHAP. "Medicaid services to this population will go a very long way to reducing both recidivism and relapse. If we are to truly fulfil our mission, we must do everything possible to protect the most vulnerable populations."

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