Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, USA.
Health Aff (Millwood). 2012 May;31(5):931-8. doi: 10.1377/hlthaff.2011.0501.
During 2009, 730,000 prisoners were released from federal and state prisons--a 21 percent increase from the number of prisoners released in 2000. Poor health and poor health coverage have been major challenges for former prisoners trying to reintegrate into the community and find work. We discuss these challenges and the likely effect of recent federal legislation, including the Second Chance Act, the Mental Health Parity and Addiction Equity Act, and the Affordable Care Act. We estimated that with the implementation of health reform, up to 33.6 percent of inmates released annually--more than 245,000 people in 2009--could enroll in Medicaid. Similarly, we estimated that up to 23.5 percent of prisoners released annually-more than 172,000 people in 2009-could be eligible for federal tax credits to defray the cost of purchasing insurance from state health exchanges. This health insurance, combined with new substance abuse services and patient-centered medical home models, could dramatically improve the health and success of former inmates as they return to the community. States should consider several policy changes to ease prisoners' transitions, including suspending rather than terminating Medicaid benefits for offenders; incorporating corrections information into eligibility determination systems; aiming Medicaid outreach and enrollment efforts at prison inmates; and designing comprehensive approaches to meeting former prisoners' health care needs.
在 2009 年，有 73 万名囚犯从联邦和州立监狱获释，比 2000 年获释的囚犯人数增加了 21%。身体欠佳和医疗保险覆盖范围不足，一直是前囚犯在努力重新融入社区和寻找工作时面临的主要挑战。我们讨论了这些挑战，以及最近的联邦立法可能产生的影响，包括《第二次机会法》、《精神健康和平等法案》和《平价医疗法案》。我们估计，随着医疗改革的实施，每年多达 33.6%的被释放囚犯——2009 年有超过 24.5 万人——可以参加医疗补助计划。同样，我们估计，每年多达 23.5%的被释放囚犯——2009 年有超过 17.2 万人——可以有资格获得联邦税收抵免，以支付从州卫生交易所购买保险的费用。这种医疗保险，再加上新的药物滥用服务和以患者为中心的医疗家庭模式，可以显著改善前囚犯在返回社区时的健康和成功状况。各州应考虑进行若干政策改革，以缓解囚犯的过渡，包括暂停而不是终止罪犯的医疗补助福利；将惩教信息纳入资格确定系统；针对监狱囚犯开展医疗补助外联和登记工作；并制定综合办法，满足前囚犯的医疗保健需求。
