This whitepaper examines the opportunities and challenges presented by the Affordable Care Act (the ACA) for criminal justice reentry.
An estimated 6.89 million individuals were under the supervision of adult correctional systems in 2013, 4.75 million under community supervision, 1.57 million in prison, and roughly 731,000 housed in local jails on any given day. With millions more passing through local jails every year, people flowing through the criminal justice system are less likely to have health coverage and often have significant healthcare needs. Yet while the criminal justice system accounts for only a small percentage of the U.S. population, an estimated 14% of residents with HIV, 33% of those with Hepatitis-C, and 40% of those with tuberculosis pass through correctional facilities, while 40% of men and nearly 60% of women in jail have at least one chronic health condition. According to numerous studies, healthcare disruptions when these individuals reenter the community have been found to lead to increased rates or re-incarceration, worse healthcare outcomes, and more costly care.
The Affordable Care Act (ACA) offers several avenues to improve health coverage and outcomes for the reentry population, including those on community supervision. This coverage promises to reduce justice and health system costs by providing healthcare access to a high-need population and ultimately improving outcomes. But these new opportunities alone are insufficient if the justice system does not leverage them to reduce costs and help close the criminal justice system’s “revolving door.” The paper presents and examines:
- An overview of relevant ACA coverage provisions
- Methods to leverage ACA opportunities for reentry populations
- Important pre-release reentry strategies for prisons and jails
- Jail admissions as a screening opportunity
- The changing role of community corrections
- Areas for further exploration
