It’s ‘life and death’: Wisconsin to extend Medicaid to those nearing release from prison

The period just after someone is released from jail or prison is crucial.

That’s especially true for those struggling with addiction, says Jerome Dillard.

It’s something he’s witnessed time and time again as a formerly incarcerated person who’s worked to support others after their release from prison.

“I just saw too many who came home and died from overdoses because they were not able to get the treatment or didn’t know how to go about getting the treatment for their addiction,” said Dillard, who has worked with Ex-Incarcerated People Organizing of Wisconsin.

A newly signed state law aims to address that critical period by extending some federal health care coverage to Wisconsinites in the months before they’re released from jail or prison.

Federal policy bars incarcerated people from getting Medicaid coverage in many circumstances.

But states can apply for waivers, creating certain exceptions. Wisconsin’s new law directs the state’s health department to apply for one of those Medicaid waivers by Jan. 1, 2027.

Assuming the waiver is granted, it would require the federal government to help pay for Medicaid coverage for eligible incarcerated people starting up to 90 days before they’re released from jail or prison.

That coverage would include case management services, medication-assisted treatment for substance use disorders and a 30-day supply of prescription medications.

Currently, Wisconsin’s Department of Health Services works with the state’s Department of Corrections so that people can apply for Medicaid while they’re still in prison. The goal is to have that coverage start for eligible people on day one of their release, according to testimony submitted by DHS.

Even so, starting Medicaid shortly before someone’s release will facilitate a “smoother care transition,” a DHS official wrote in legislative testimony.

Dillard says the new law will help with continuity of care. He says that’s key to making sure that someone doesn’t relapse — or reoffend.

“Reentry should start before release,” Dillard said shortly before the legislation was signed. “This bill is a practical, humane step that can save lives and strengthen our communities and get individuals the care that they need.”

“It’s life or death, life and death, in my opinion,” he added.

Prisons and local jails are already legally required to provide health care coverage to the people incarcerated there.

By having some of those costs reimbursed through Medicaid, “this bill just shifts a portion of the burden onto the federal government,” co-author Rep. Clint Moses, R- Menomonie, wrote in testimony attached to the bill.

“The savings generated through this federal match could be reinvested to expand treatment services and further reduce the financial burden on Wisconsin taxpayers,” Moses continued.

Wisconsin’s Department of Health Services estimated the new law could eventually cost the state’s Medicaid program $8.7 million a year.

At the same time, the changes could lead to lower costs to jails and prisons. Wisconsin’s Department of Corrections estimated the Medicaid waiver would save the state’s prison system more than $750,000 a year. It could could also lead to “indeterminate” cost savings for local jails.

“Because not all local detention facilities provide the same type or level of services, DOC is unable to estimate the potential local cost savings,” DOC officials wrote.

The groups that registered in favor of the legislation included those responsible for overseeing county jails, including the Wisconsin Counties Association and the Badger State Sheriffs’ Association.

Democratic Gov. Tony Evers signed the bill into law earlier this week after it advanced with bipartisan support.

The measure passed Wisconsin’s GOP-controlled Assembly in February with a voice vote, meaning there wasn’t a roll call to mark exactly who voted for and against.

It cleared the Senate in March, with only Sen. Steve Nass, R-Whitewater, voting against.

More than a dozen other states have similar waivers in place, allowing people to get Medicaid coverage when they’re nearing release from jail or prison.

If you or someone you know is struggling with addiction, call the Wisconsin Addiction Recovery Helpline at 211 or text your ZIP code to 898211. You can also learn more about treatment options or how to respond to an overdose at: dhs.wisconsin.gov/opioids.

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