For those with untreated health issues, the cycle only continues. If they don’t have any access to treatment in the outside world, they may start self-medicating with drugs and alcohol.
“Next thing you know, they’re caught for heroin possession, or commit a crime that facilitates their addiction,” said Ben Breit, the communications director for Cook County Sheriff Department in Illinois. “And then they’re back where they started.”
The consequences could be even more serious than that. A study of Washington state inmates, for example, found that during the first two weeks following an inmate’s release, their risk of dying was 12 times higher than other state residents. The leading causes? Issues that stem from a lack of proper treatment — like drug overdoses, heart attacks, and suicide.
Breit works under Sheriff Tom Dart, the man who led Cook County Prison’s transformation into the nation’s largest mental health provider, where security guards are required to have a background in medicine and inmates are treated as patients before prisoners. The caliber of care easily beats what little public health options exist for low-income or homeless people living in or around Chicago. In fact, according to Breit, “tons and tons of people” in the area intentionally commit crimes to receive health care behind bars.
Leaving prison with Medicaid coverage, Breit said, throws a wrench in that cycle.
“Medicaid enrollment is such an important step in this process,” said Breit. “Getting [former inmates] well, giving them a chance to thrive outside the criminal justice system… If we can successfully do this, we’re going to save hundreds, thousands — if not millions — of dollars on the back end in taxpayer dollars. They’re the ones paying for prison health care right now. It doesn’t have to be that way.”
Cook County Prison didn’t need HHS’ reminder to sign up prisoners for Medicaid. In fact, registering inmates for health insurance has been part of its prisoner intake process for three years. They enroll everyone in Medicaid coverage that will kick in when they get out.