How does the Affordable Care Act impact offenders and agencies?

Tom Reid
posted this on March 04, 2013 07:36 AM

Last Updated November 2013


We are a local jail. We need to know how the Affordable Care Act (ACA) will impact inmates while in jail and upon release.


That is a very timely question. In 2014, the Affordable Care Act will change eligibility requirements for Medicaid, and this can have an impact upon jail inmates who are not yet sentenced. Sentenced inmates in state and local facilities will not fall under the new guidelines until released. 

Currently, offenders, many of whom are low-income, do not qualify for Medicaid unless they meet stringent disability requirements and are unable to work. This leaves many of those released from correctional facilities uninsured. Starting January 1, 2014, individuals with household incomes at or below 133 percent of the federal poverty level (FPL) will be eligible for Medicaid regardless of disability status.

What about  penalties for not having health insurance under the ACA?  Though nearly everyone is required to be enrolled in an approved health insurance plan every month starting on January 1, 2014, those incarcerated for more than a month are exempted from this requirement during the term of their incarceration.  As soon as an individual is released from incarceration, either with or without community supervision, this exemption no longer exists (assuming they meet the other requirements).

What you can do? Corrections officials can work with local and state health officials to ensure that individuals are enrolled in Medicaid at the time of release under the new eligibility requirements in 2014. Also,  include information about the Affordable Care Act and participation in state health insurance exchanges as part of re-entry and pre-release casework planning services.

As the Affordable Care Act becomes fully implemented, there could be further interpretations and adjustments to it, so check with local or state health officials for information. 

Here are some resources for you:


027663: Frequently Asked Questions (FAQ): The Affordable Care Act (ACA) and Justice-Involved Populations -- 2013
026703: State Strategies for Controlling Inmate Health Care Costs -- 2012
027180: The Implications of the Affordable Care Act on People Involved with the Criminal Justice System -- 2013 
 026525: The Affordable Care Act: Implications for Public Safety and Corrections Population
026189: Containing the Growth of Spending in the U.S. Health System (Includes Affordable care Act section) 
024963: Increasing Access to Health Insurance Coverage for Pre-Trial Detainees and Individuals Transitioning from Correctional Facilities Under the Patient Protection and Affordable Care Act
026704: Key Elements of the Affordable Care Act: Interface with Correctional Settings and Inmate Health Care
White Paper: The Affordable Care Act and Criminal Justice: Intersections and Implications
026253: County Jails and the Affordable Care Act:  Enrolling Eligible Individuals in Health Coverage

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