Nearly half of all prison inmates are now eligible for Medicaid, thanks to provisions in the Affordable Care Act that allow states to expand the program.
Under Obamacare, 27 states opted to expand Medicaid eligibility to include adults with incomes less than 133 percent of the federal poverty level.
Previously, Medicaid coverage was limited to a select group of low-income individuals such as pregnant women, the elderly and the disabled.
But most of the estimated 600,000 inmates incarcerated in states that expanded Medicaid can now enroll in the program, according to a Government Accountability Office report released Tuesday.
While only 2 percent of inmates in North Carolina, where lawmakers chose to preserve existing Medicaid eligibility rules, are able to enroll in the program, 90 percent of Colorado inmates will be eligible for Medicaid in January.
Federal law bans states from obtaining Medicaid matching funds to provide medical services to inmates — except when the inmate is a patient at a hospital or other independent healthcare institution.
The restriction is intended to prevent the federal government from paying for services that should be the responsibility of state and local governments.
To be eligible for Medicaid matching funds an inmate must spend at least 24 hours as an admitted hospital patient.
Inpatient procedures in a correctional facility such as a prison infirmary don’t qualify for matching funds, nor do outpatient procedures at any medical center.
However, the GAO report said state Medicaid agencies aren’t required to identify enrollees as inmates or make sure inmates are eligible for the services they receive.
The federal government could therefore shell out millions of dollars in matching funds for healthcare services states are obligated to cover.
In 2013, nearly 3,000 Medicaid-eligible California inmates stayed 24 hours in a hospital, racking up an estimated $38.5 million in matching funds.
Still, the Medicaid funds California received as reimbursement for inmate care amounted to only 1 percent of the state’s total Medicaid bill.
Some states are finding ways to collect even more federal funds from the program.
In five of the six states GAO reviewed, including North Carolina and Pennsylvania, state governments have begun using taxpayer dollars to hire and train staff to enroll inmates in Medicaid.
All five of those states now require contracted hospitals to accept Medicaid rates or collect matching funds from the program for allowable services.
Although the GAO report anticipates an increase in federal spending on inmate healthcare thanks to Obamacare, it concludes that growth in such spending is “likely to be limited,” suggesting that no more than 5 percent of all inmates will receive the overnight inpatient care required for states to bill Medicaid.
Go here to read the complete GAO report.
