Oregon gains approval to provide Medicaid coverage to people leaving incarceration

SALEM, Ore. (KTVZ) – Oregon has been approved to use federal funding to allow people who are incarcerated to access Medicaid coverage 90 days prior to release, in an effort to support their reentry into the community and prevent gaps in physical and mental health care after release.

Federal law currently prohibits the use of federal Medicaid funds for health care services for people when they are inmates of public institutions. This means Oregon Health Plan members have their Medicaid enrollment suspended once they enter incarceration, even if it is for a brief time; when they leave incarceration and restart health coverage, there is often a delay in access to medications, linking to community-based providers, and receiving physical, mental health, and addiction treatment.  

“This approval is an important first step in making it possible for people leaving a carceral setting to be able to better access the care they need, including medications for opioid use disorders,” said Dave Baden, deputy director for Policy and Programs. “Oregon Health Authority is looking forward to working with carceral institutions and community partners to build these services in the coming years to make them available.”

Services will apply to people in state prisons, county jails, state and county youth correctional facilities. There are more than 60 institutions in Oregon with more than 20,000 beds anticipated to be eligible to participate.

Oregon has been in negotiations with the Centers for Medicare and Medicaid Services since February 2022. During that time, OHA has been listening to the needs of state and local partners about the expansion of Medicaid benefits in carceral settings. Several leaders responded to today’s news with support:

• “This decision is exciting and a gigantic step in our attempt of successful rehabilitation for those incarcerated returning to the community,” said Captain Lee Eby, Jail Commander, Clackamas County Sheriff’s Office. “I have seen the effects of our current system where the gap experienced hinders desperately needed access to care and services for those leaving incarceration to continue down their path of recovery.  This funding will be a huge tool for jail and prisons in helping those incarcerated receive proper discharge planning for successful reentry into the community, ensuring the continuation of care for one of our most vulnerable populations.”
• “The Department of Corrections looks forward to providing those releasing from our care and custody any additional resources possible,” said Michael Reese, Director of Oregon Department of Corrections. “Having Medicaid services prior to reentering Oregon’s communities is one step in ensuring continuity of care and community standards of care when individuals walk out the door.”
• Similar to other Oregon youth, youth in Oregon Youth Authority facilities are presenting with more complex mental health conditions, including substance use disorder. Joe O’Leary, Director of the Oregon Youth Authority, noted that CMS’s decision will not only support treatment while youth are in facilities, but also facilitate continuity of care when youth transition back to communities.

“Oregonians are safer when justice-involved youth get the health care they need both during and after their time with us,” said O’Leary. “This decision will boost outcomes for our youth and help them lead productive, crime-free lives.”

The U.S. Department of Health and Human Services, through CMS, granted OHA authority for the new benefit on Tuesday.