Health Aff (Millwood). 2014 Mar;33(3):455-61. doi: 10.1377/hlthaff.2013.1132.
The expansion of Medicaid eligibility to Americans with incomes up to 138 percent of the federal poverty level should greatly increase access to coverage and services for people recently released from jail and, thus, improve health outcomes and reduce recidivism in this population. The population is disproportionately male, minority, and poor; suffers from high rates of mental and substance abuse disorders; and is expected to make up a substantial portion of the Medicaid expansion population. To ensure connections to needed services after release from jail, states could help inmates determine their eligibility and enroll in Medicaid; take advantage of federal grants to automate systems that determine eligibility; and include a robust array of behavioral health services in Medicaid benefit packages. In most states, new partnerships between Medicaid and corrections agencies at both the state and local levels will be needed to support these activities.
将医疗补助计划的资格扩大到收入达到联邦贫困线 138%的美国人,应该会大大增加最近从监狱获释的人的获得保险和服务的机会,从而改善这一人群的健康状况并降低累犯率。这个人群中男性、少数族裔和贫困人口的比例过高;患有高比例的精神和物质滥用障碍;预计将占医疗补助计划扩大人群的很大一部分。为了确保这些人在出狱后能够获得所需的服务,各州可以帮助囚犯确定其资格并参加医疗补助计划;利用联邦拨款实现确定资格的系统自动化;并在医疗补助福利包中纳入一系列广泛的行为健康服务。在大多数州,都需要在州和地方各级建立医疗补助和惩教机构之间的新伙伴关系,以支持这些活动。