When a person is released from incarceration, they often are faced with rebuilding their lives from scratch – lacking basic government identification, like a driver's license, stable income, housing or access to health care – all with the stigma of incarceration attached to them. But a number of states are working to make it easier for people leaving prison to get the health care they need as soon as they are released, eliminating coverage gaps that otherwise take long periods of time or mountains of paperwork to resolve.
California in January became the first state in the nation to offer Medicaid to people up to 90 days prior to their release from incarceration. More than a dozen other states are exploring similar changes to streamline access to Medicaid and make it easier for people to receive the care they need.
To learn more about these policies and what's at stake, the PBS NewsHour's Laura Santhanam spoke to Ryan Levi, a producer for Tradeoffs, a national health policy podcast, who has reported extensively on how these issues are playing out.
Watch the conversation in the player above.
Why health care takes a back seat
The weeks following release from U.S. prisons and jails can be dangerous for people. According to a landmark 2007 study using data from Washington State and published in the New England Journal of Medicine, researchers found that people leaving incarceration were 12 times more likely to die than non-incarcerated people during the first two weeks after release. Some of the most common causes of death for this population group included fatal drug overdoses, cancer, cardiovascular disease, homicide and suicide.
"When someone leaves jail or prison, they're on their own pretty much to go and find their own new doctor to get their prescriptions filled, to get their insurance," Levi said. "And these folks are also, you know, at that same time trying to find a place to live, find a new job, reconnect with family and friends. There's a lot on their plate. And health care often takes a backseat."
READ MORE: Why cancer patients leaving prison struggle to get care
A new roadmap for states to offer care
On April 17, the Centers for Medicare and Medicaid Services offered guidance about improving the transition for Medicaid-eligible individuals leaving incarceration. It encourages states to propose new ideas to offer health care that "will test innovative approaches to coverage and quality to improve care transitions, starting pre-release, for individuals who are incarcerated, thereby facilitating improved continuity of care once the individual is released."
Levi said it's important to remember that "Medicaid doesn't guarantee that they're going to get the care they need," and that "getting the care someone needs doesn't guarantee that they are going to have … the broader outcomes that they want for themselves and that we as a society want for them."
But what the guidance offers is a road map that allows "states to say, hey, if you want to offer this coverage, if you want to provide Medicaid for people who are still in jail and prison, this is what we're looking for," Levi said.