Study: More Medicaid Needed for Incarcerated Individuals with Substance Abuse Disorders

A new study examining how state Medicaid programs are helping people with substance use disorders (SUD) uncovered the need to expand the programmatic features to assist individuals who are transitioning in and out of the criminal justice system.

The study, “State Medicaid Initiatives Targeting Substance Use Disorder in Criminal Legal Settings, 2021,” was published in the American Journal of Public Health and was cowritten by Faye Taxman, director of the Advancement for Correctional Excellence (ACE!) at the Schar School of Policy and Government at George Mason University.

In 2021, a survey was sent to all 50 U.S. states and Washington, D.C. The survey asked if they had any special programs for individuals with SUD in the criminal justice system, including jails, prisons, and community corrections. An impressive 90 percent of those contacted responded to the survey.

The survey found that most states did not have specific Medicaid programs targeting people with SUD in the criminal justice system.

However, 18 states and Washington, D.C., introduced at least one type of Medicaid initiative. The most common efforts involved providing medication to treat opioid addiction before release and helping individuals sign up for Medicaid.

Another frequent initiative involved making it easier for individuals to keep their Medicaid by suspending rather than canceling their benefits when they are incarcerated. The least common initiative involved coordinating care for individuals with SUD.

“There is a clear need for more states to adopt such initiatives, particularly given the high risk of overdose deaths in this population,” said Taxman. “This has implications for new policies that states can apply for in terms of [Social Security Act] Section 1115 waivers to enhance Medicaid funding for those in the criminal legal system.”

The full text of the study is available on the American Journal of Public Health website.