The federal government is planning to allow states to use Medicaid funds to provide drugs to combat addiction and other medical services for people at state jails and prisons in an effort to help some of those most at risk of dying in the nation's overdose epidemic.
Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, announced Tuesday that states would be encouraged to submit proposals for how to use money from the joint federal-state low-income health insurance program for incarcerated people. Those that do would be required to provide mental health and drug treatment and would have the option to add some other services.
Speaking during a visit to New Jersey's Camden County Jail, Gupta said the U.S. Centers for Medicare and Medicaid Services will release its full guidance this spring.
Advocates have long called for such a move and the government last month announced that California was being given approval to use Medicaid for some services for incarcerated people.
“Treating substance abuse disorder in prison and jails is smart,” said Gupta, who also announced that by summer all federal prisons will be offering medications to treat substance use disorder. “It's a smart move for our economic prosperity, for our safety and health of our nation.”
The Medicaid plan represents a departure for the joint federal-state health insurance program for low-income people. When it was launched in 1965, it came with a ban on using the funds to help incarcerated people.
Studies have found that the majority of people incarcerated in jails and state prisons met the criteria for drug dependence or abuse — and that former inmates are far more likely to die in their first weeks after release than the average non-incarcerated person. The leading cause of death for people newly released is overdose, partly because tolerance to drugs decreases for people who don't use them while incarcerated.
Advocates for allowing Medicaid to fund treatment in lockups say it could keep people alive and reduce crime.
“We’re really hopeful that this coverage will help people improve their health outcomes and avoid additional involvement in the criminal justice system,” Gabrielle de la Gueronniere, the vice president for health and justice policy at the Legal Action Center, said in an interview Tuesday.
In some places, the Medicaid change could usher in new drug treatment options.
But in New Jersey, it's largely a financial change. State Human Services Commissioner Sarah Adelman said 20 of the state's 21 counties already have medication-assisted treatment programs at their jails.
The treatment costs are high, particularly for Sublocade, an opioid addiction treatment drug administered through a shot every four weeks. Since 2019, the Camden County Jail has spent more than $528,000 since 2019 to provide the drug to 170 people. It has cost $664,000 to provide a similar drug in a daily pill to about 3,100 people. The funding comes through the state's SAFE program, which uses state allocations and grant money. In the Camden facility, nearly one-fourth of incarcerated people are receiving medication treatment now.
“It allows us to use those SAFE dollars to go further and to do more,” said Sarah Adelman, the state human services commissioner.
Some Camden County Jail inmates spoke with Gupta before he made his announcement.
One, Rachel Parker, said that she was already being treated with Suboxone when she was brought to the jail in early January.
Past jail stays meant a painful withdrawal, making it even more stressful to be there.
“It's like you're fearing death,” she said.
But she said this time, she's been able to keep getting treated and knows that when she's released, she'll have a prescription to continue her treatment.
