When President Obama signed the Affordable Care Act into law in 2011, it was impossible to know all the ways in which it would take effect. Health care and the insurance industry have been evolving without much policy and regulation interference for some time, and as a result, some people and vulnerable populations fell through the cracks. One place where the ACA looks to be directing attention is in the health care cracks in corrections.
With the highest incarceration rate in the world, and roughly half of all those incarcerated suffering from mental health issues, the United States’ correctional system has a vast health care crisis on its hands. Whether you’re a veteran corrections officer or a student just starting your graduate program in forensic psychology, the Affordable Care Act has the potential to change how and why America’s prisons are filled. It’s a change that will have far-reaching implications throughout society. Here is a brief look at some of the ways the ACA is changing incarceration across the country.
Cost Savings at the State and Local Levels
Most states are strapped for cash, and prisons cost a lot to run. With over 2.4 million people in the prison system at a cost of at least $20,000 per person per year, it’s no wonder that some states and counties are shifting health care burdens to the federal government. It’s a budgetary windfall for the state governments in the early stages of the pilot program. Savings are projected to be as much as $6.5 billion a year.
Healthier Prisoners and Parolees Mean Healthier Communities
The expansion of Medicare under the ACA actually allows for many of the mentally ill within America’s prison system to get mental health treatment for the first time. When these individuals are released, they likely will still qualify for Medicare, which means they can continue treatment for mental health needs and substance abuse issues — two primary reasons why people end up in jail in the first place. Recidivism, or the habitual relapse into crime, will most likely be reduced due to the expansion of care. Not only will prisoners and parolees be healthier, both in body and mind, but that health will lead to a reduced rate of repeat incarcerations, positively affecting the communities, neighborhoods and families of the incarcerated as well.
Increased Public Safety
The undergirding logic of incarceration isn’t just one of punishing those who do wrong; it’s also exists to keep law-abiding society safe. When people struggle with unmet mental health needs or substance abuse issues, they often engage in unsafe behavior. By extending health care to those whose behavior can be erratic or dangerous enough to warrant arrest, the public’s safety will genuinely increase.
Reduced Spending on Prisoners Overall
As more and more states and local governments move toward adopting the federal mandate and seeing to it that prisoners have health insurance — during and after their sentence — it is projected that overall spending will go down. The health needs of the populations that end up in prison are myriad. Many have chronic and communicable diseases that have not been adequately dealt with because prior to the Affordable Care Act 90 percent of those incarcerated did not have health insurance of any kind. As treatment of bodily, mental and emotional needs becomes more commonplace, the diseases and problems that wreaked havoc on prisoners and prisons’ budgets will lessen. It is estimated that cost savings will run around $2,500 per inmate and that repeat incarcerations will be reduced by at least 20 percent.
Reduced Criminalization of the Mentally Ill
Outside of the prisons’ walls are those who suffer from mental illness, have been faced with inadequate or no treatment and have not yet committed a crime egregious enough to land them in handcuffs. Because of the Affordable Care Act and the expansion of Medicare, people who, in the past, would have eventually become criminalized due to unmet mental health needs might never become so.
While it seems to have been a largely unforeseen consequence of the legislation, the Affordable Care Act is shaping up to provide some extensive and far-reaching prison reform. It still remains to be seen whether that reform will be as sweeping as it looks like it might be, but hope exists that unmet health needs will no longer be the cause prison time. .
