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Can ACA cut into crime?

| August 21, 2014 9:00 PM

Can the new Affordable Care Act, a.k.a. Obamacare, have a positive impact on crime? Some prison officials in places such as Chicago and Connecticut, as well as experts at the crime research Urban Institute, think the answer is yes.

For the first time, Medicaid-provided health insurance is available by law to low-income (i.e., most) prisoners exiting the system. According to the Bureau of Justice Statistics, half of America's prisoners nationwide have identified mental illness and/or substance abuse issues. So half of the eight million departing prisoners each year received some combination of medication and/or counseling while in prison - many for the first time in their lives.

What tends to happen is that upon leaving they lose this care. Those with psychiatric illnesses (about one million, according to the Department of Justice) may receive a handful of medication upon exit, but nothing in place to continue that. Most can't afford it and until now, haven't been insured.

Result: High rates of recidivism. Revolving-door incarceration. An endless cycle of reoffending, including the economic and emotional costs to society. Continued health care to treat the DOJ-estimated one million with mental illness and 60 to 80 percent with drug abuse history has been the exception.

What if it became the rule?

Enter the ACA and at a growing number of prisons in opt-in states with a brand new exit procedure that includes the paperwork necessary to enroll in the program and treat ongoing health issues. Yes, many of these folks start out with Uncle Sam footing their part of Medicaid's $265 billion total insurance bill, which can range $2,000-$10,000 per person. But as prison and health officials nationwide have pointed out, healthier lives mean better odds of stability. Either way the healthcare tab is cheaper than the $25,000-$75,000 annual cost range of incarcerating the individual yet again (which includes constitutionally protected healthcare anyway), not to mention the benefit to society of less crime.

It's only just begun, but some research already provides promise. A 2010 Washington State Institute of Public Policy study cited in The Monitor Weekly found that among state residents enrolled in Medicaid and receiving substance abuse treatment, arrest rates dropped up to 33 percent, compared with those not receiving treatment.

Time will tell. Since the ACA became effective last fall, ex-offenders account for 1 in 6 new Medicaid enrollees. Politics aside, less crime is one goal everyone shares.

Sholeh Patrick, J. D. is a columnist for the Hagdone News Network. Contact her at Sholeh@cdapress.com.