Former inmates face big challenges in accessing health care upon reentry

Four days before Christmas in 2018, federal inmates serving lengthy or life sentences received the best gift they had in years. After decades of advocacy, the First Step Act, signed into law on December 21, would immediately allow many who were set to die in prison a second chance. For many it was likely an answer to years of prayers. 

Six months after the passage of this landmark bipartisan legislation, which reduced mandatory minimum sentences for non-violent drug convictions, about 1,100 inmates who were imprisoned due to “war-on-drugs” policies have been released from federal prisons. Another 2,200 are on target for release. 

These inmates have Donald J. Trump, whose 2016 presidential campaign paradoxically promoted him as being tough on crime, to thank for their second chance and they have done so at events the White House has hosted this year to mark the Trump administration’s achievement. 

But even as Mr. Trump basks in the praise he is receiving from former inmates for signing the First Step Act into law, some advocates may want hold their platitudes until they review his stance on health care policy and the potential impact it may have on reentry and reintegration for this population of older returning citizens.

In a story published in the Crime Report, I wrote about how the current administration’s policies that weaken Medicaid expansion to childless adults by imposing work requirements could lead to fewer options for these returning citizens to receive health care services upon leaving prison. The passage of the Affordable Care Act led to demonstration projects in several states that opened Medicaid enrollment to former inmates, with some states collaborating with correctional agencies to enroll inmates prior to their prison release date. 

In my story, I talk to a newly minted Ph.D. whose dissertation on the reentry experiences of older inmates found that access to physical and mental health care services are critical to this population. According to gerontologists, many in this group are returning to their communities older and sicker than people of comparable ages in their community. As public sentiment shifts toward decarceration policies that specifically address harsh sentences for drug convictions, state lawmakers have been working on legislation similar to the federal First Step Act that could  reduce populations in state correctional facilities and lead to a greater number of older inmates returning home in the coming years. 

As a Dennis A. Hunt Fund fellow and 2019 National Fellow, my next series of stories will seek to explore how the impoverished communities to which former inmates often return might respond and absorb these returning citizens.