According to this brief from The Health and Reentry Project (HARP), new Medicaid policies have great potential to benefit people with mental health conditions and substance use disorder (SUD), who are overrepresented in the criminal justice system and may have experienced significant gaps in access to services before, during, or after incarceration. They also have the potential to greatly benefit people with physical health conditions.

This brief describes the changes that state and federal governments are making and their potential implications for people with mental health conditions and SUD. It focuses on changes being made in specific states through Medicaid demonstration waiver authority that focus on providing services at reentry. It also discusses national changes made through recent federal legislation that take effect in 2025. Finally, this brief describes legislative proposals that Congress is considering to further expand Medicaid’s role as people leave carceral facilities and concludes by identifying next steps for these policies.