Medicaid and Corrections
Recent Medicaid guidance and legislative developments offer new opportunities for correctional leaders to leverage Medicaid to enhance outcomes for people who are incarcerated. With the passage of the SUPPORT Act, the Consolidated Appropriations Acts of 2023 and 2024, and new guidance around the Medicaid Section 1115 Reentry Demonstration Opportunity, prisons and jails have more opportunities to work with their state Medicaid agencies to support individuals not only during incarceration but also during the critical transition from incarceration to the community.
This webpage provides a curated list of resources to support correctional leaders in taking full advantage of these new opportunities.
Understanding the New Medicaid Requirements and Opportunities
The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act), Consolidated Appropriations Acts of 2023 and 2024 (referred to as the 2023 CAA and 2024 CAA, respectively), and the Medicaid Section 1115 Reentry Demonstration Opportunity collectively represent a significant shift in how Medicaid can be utilized to support people in the justice system.
Key provisions in the SUPPORT Act include maintaining Medicaid eligibility for youth under 21 and former foster care youth up to age 26 during incarceration, ensuring continuous access to essential health services upon release, and mandating state coverage for medications to treat substance use disorders (also known as medication-assisted treatment, or MAT).
The 2023 CAA makes significant changes to Medicaid and CHIP for youth and young adults, including requirements to provide screening and diagnostic services 30 days before release or as soon as practicable and targeted case management 30 days before and continuing after release. These changes are effective January 1, 2025, for young people.
The 2024 CAA mandates that, beginning on January 1, 2026, states suspend rather than terminate Medicaid enrollment during incarceration. These measures aim to support successful reintegration through the early identification of physical and behavioral health care needs during incarceration and linkages to care upon release.
Additionally, the Medicaid Section 1115 Reentry Demonstration Opportunity is an opportunity for states to apply to access federal Medicaid funding to provide critical pre-release resources for physical and behavioral health care in corrections settings for up to 90 days before release and for pre- and post-release care management to promote individuals’ seamless transitions into the community.
