Federal officials have approved Oregon’s request to offer free Medicaid services for addiction and some other services to people who are on the verge of being released from jail or prison, something that’s prohibited by federal law.
The U.S. Department of Health and Human Services said Oregon will offer the new program, along with Illinois, Kentucky, Utah and Vermont. They’re joining California, Massachusetts, Montana and Washington state which first piloted programs offering some Medicaid services to people about to be released.
Inmates who meet Medicaid’s low-income income limits will qualify for coverage 90 days before their release from jail or state or federal prison. They’ll be eligible for lab and radiology services along with mental health assessments, medication to keep people off opioids and some mental health medication targeting severe illness.
When people are jailed or imprisoned, they lose their Medicaid coverage, and they have to reapply once they’re out. That leads to health care gaps. Studies show that people who end up in prison or jail have higher rates than the general public of physical and mental illness, including hypertension, asthma, tuberculosis, hepatitis B and C and HIV, and higher rates of premature death from infectious and chronic diseases, drug use and suicide.
“For people involved in the justice system, ensuring a successful transition back into the community includes having the health care supports and services they need,” Health and Human Services Secretary Xavier Becerra said in a statement.
This program aims to give people a seamless health care transition as they reenter the community and try to rebuild their lives. Being screened for mental health issues while still behind bars is expected to help them get counseling or other treatment more quickly when they’re out.
“Fifty percent of all people in Oregon prisons have been diagnosed with a disability or mental illness, which makes uninterrupted care really important,” Amy Bacher, an Oregon Health Authority spokeswoman, said in a statement.
Lawmakers tackle issue
Approval of the program follows passage of House Bill 4002 by the Oregon Legislature. The law directs $211 million toward tackling addiction, including building new diversion programs for those who are charged with possessing a small amount of illegal substances. It also includes $10 million to screen people in jail for opioid addiction and to treat them with medication so that they can stabilize their lives and continue their recovery when they’re released.
About 65% of people behind bars have an addiction problem, according to the Centers for Medicare and Medicaid Services, but they’re often not screened or treated. This $10 million allocation – and the just-approved Medicaid program – aims to address that issue. Democratic Rep. Pam Marsh of Ashland, who was behind the push in the Legislature to offer medication treatment for opioid use in jail, welcomed approval of the program.
“I’m thrilled with the approval of the Medicaid waiver, which will provide long-term sustainability to continue and expand opioid medication treatment in our jails,” Marsh told the Capital Chronicle. “These services are critical if we want to break the cycle of addiction, criminality, and incarceration — and to save lives in that process.”
Opioid overdoses have skyrocketed in Oregon in recent years with the spread of fentanyl, which can be fatal in tiny doses and is mixed into counterfeit opioid pills that sell on the streets for as little as a dollar. According to the Oregon Health Authority, 280 people died in Oregon from fatal opioid overdoses in 2019. That soared to about 1,050 in 2023.
The Medicaid program marks an attempt by the Biden administration to address the nationwide addiction crisis.
“Expanding access to life-saving treatment and recovery supports for incarcerated people is a critical part of our bipartisan efforts to beat the overdose epidemic and save lives,” Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, said in a statement.
The Centers for Medicare and Medicaid Services said thousands of people would benefit across the newly approved programs in the five states, but it’s unclear how many will qualify in Oregon. The Oregon Health Authority did not respond to a question about that. Oregon has county jails across the state, a federal prison that houses more than 1,500 men, 12 state prisons for about 12,000 adults between 18 and 91 years old and 35 young people between 18 and 24 years old who are locked up.
The cost is also unclear, but the majority will come from federal coffers. The federal government pays for about 60% of Medicaid, while the state pays the rest.
The health authority did not say when the program would launch.
“We’ll be working on timeframes for implementation and will have a lot of work with carceral settings to be ready for this,” Bacher said in the statement.
Oregon Capital Chronicle
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