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MADISON – Changes in Medicaid guidelines affecting inmates will take effect later this month, state officials announced Friday in a press release.

Starting Oct. 24, incarcerated Medicaid members will have their health care benefits suspended and re-evaluated before they are released from jail or prison. Under the current policy, Medicaid members have their coverage terminated when they became incarcerated. As a result, the program delayed their access to medical and behavioral health care after their release. A federal program administered by the state, Medicaid provides health care services to low-income people.

The Wisconsin Department of Health Services (DHS) and the Wisconsin Department of Corrections (DOC), working with income maintenance agencies and community partners, made the changes.

“This new policy will increase the likelihood of successful re-entry for Wisconsin residents into their communities,” DHS Secretary-designee Andrea Palm said in a news release. “Connecting incarcerated individuals to health care, and other support services upon their release is critical to breaking the cycles of chronic homelessness, reliance on emergency care and re-arrest.”

Delays in care can result in increased adverse health outcomes and rates of re-arrest. According to the Kaiser Family Foundation, incarcerated individuals are more likely to have chronic physical and mental health conditions, serious mental illnesses, or substance abuse disorders. In the two weeks after their release, adults leaving jail or prison face a mortality rate that is 12.7 times higher than the rest of the adult population, according to the press release.

According to the report:

“Medicaid coverage for individuals moving into and out of incarceration may help increase their access to care and improve their health status, and thus contribute to broader benefits. Enrolling these individuals in Medicaid may also contribute to state savings. The Affordable Care Act’s (ACA) Medicaid expansion offers a new opportunity for states to connect individuals in prisons and jails to coverage.

“However, Medicaid eligibility policies for incarcerated individuals vary in both expansion and non-expansion states. These policies affect if and when individuals may be enrolled in coverage and the savings states may achieve from their coverage.”

As of Oct. 9, the DOC’s Division of Adult Institutions was supervising 20,953 people. Of the 9,585 Wisconsin people released from jail or prison during the 2019 Federal Fiscal Year, nearly 70 percent were eligible for a Medicaid program.

The new policy is also expected to reduce expense pressure on community organizations and free or low-cost clinics. Because Medicaid will pay for inpatient hospital expenses for inmates with suspended benefits, the policy should result in cost savings for the DOC and local county jails.


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Paul Holley is retired from careers in journalism, public relations and marketing but not from life. These days, he pretty much writes about what he feels like writing. You may contact him directly at:...