Invest in Louisiana (formerly the Louisiana Budget Project) writes in support of LDH’s Reentry 1115 Waiver Application to make Medicaid benefits available for incarcerated people 90 days prior to their release. If approved, this waiver will enhance public safety by reducing risk factors for recidivism at little cost to the state, providing a cost-effective means of reducing crime.

With the highest incarceration rate in the country nearly every year, Louisiana also experiences one of the highest rates of recidivism. One common reason for re-incarceration is a return to criminal activity in the face of obstacles to medical care, among other important social services, especially for individuals suffering from substance-use disorders. 

From  2019 through 2023, an average of over 14,800 people were released from Louisiana prisons and jails each year. With 73% of incarcerated individuals in the state having substance use disorders that contributed to their incarceration and an estimated 28% of the incarcerated population having a diagnosed mental illness, it is imperative that such individuals have access to continuous medical care, including medication, behavioral health and peer support services, and medical equipment. Significant proportions of the incarcerated population have also been diagnosed with chronic illnesses such as diabetes, cancer, COPD, and heart disease, indicating a need for continued medical care upon release. Establishing Medicaid coverage 90 days prior to release will help to ensure that vulnerable populations receive services needed to avoid recidivating.

A successful version of this program should include mechanisms for ensuring continued coverage after release, including through facilitated connection with service providers, clinics, and pharmacies. Additionally, educational materials with information on retaining coverage after release should be provided to all eligible incarcerated persons with opportunities for consultations. Because some incarcerated people are released with a notice much shorter than the 90-day time period contemplated by LDH’s waiver application, a system should also be established to ensure such people are enrolled in Medicaid prior to their release. Such a system might involve completing the necessary enrollment paperwork for people with upcoming parole hearings, so that the applications may be submitted immediately upon the granting of parole.