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AFFORDABLE CARE
ACT
The ACA is scheduled to
take effect in January 2014. This expansion could
potentially have great implications for counties and jails
that fund the medical needs of their inmates.
Inmate Coverage Through A State
Insurance Exchange
- By 2014 the ACA
requires that health insurance exchanges be established in
each state.
- There is a specific ACA
provision related to the exchanges that could
significantly impact county jails, which states that:
- “An individual shall
not be treated as a qualified individual, if at the time
of enrollment; the individual is incarcerated, other than
incarceration pending disposition of charges.”
- This provision will
likely allow eligible inmates who are pending disposition
of charges to enroll in a health insurance plan through
their state insurance exchange prior to conviction, or
maintain coverage if the inmate is already enrolled.
Medicaid Eligibility For Inmates
- All individuals under
age 65 who have incomes up to 133% of the federal poverty
level.
- Many inmates will fall
into this category because a majority of county jail
inmates are young, low-income males who did not previously
qualify.
- Inmates can be enrolled
while incarcerated so that they can begin receiving
Medicaid benefits once released from custody.
Will Medicaid Pay For An
Inmate’s Medical Bills
- Unlike the provision
allowing pre-adjudicated inmates to obtain and continue
health insurance coverage though a state insurance
exchange, federal law does not allow for federal Medicaid
funding to pay for medical care provided to individuals
who are “inmates of a public institution”.
- There may be an
exception to this rule however if an inmate is Medicaid
eligible, continues to be enrolled in Medicaid while
incarcerated and becomes an inpatient in a hospital.
While the expansion of the
ACA could cause the above changes, many states are suing the
federal government over, among other things, the new
Medicaid eligibility guidelines. CRS will continue to stay
up to date on these changes as they occur. For more
information please contact us.
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