Medicaid Inmate Exclusion Policy
The Medicaid Inmate Exclusion Policy (MIEP) refers to a provision in the United States federal health insurance program Medicaid that bars incarcerated individuals from receiving benefits.[1]
Medicaid was established by the Social Security Amendments of 1965. Medicaid provides health insurance for adults and children with limited income and resources. It contains a provision that excludes from eligibility "inmate[s] of a public institution."[2] This provision is commonly referred to as the Medicaid Inmate Exclusion Policy.[3][4][5]
Effects
The MIEP has several effects on the provision of healthcare to incarcerated populations
- Medicaid is the largest source of funding for medical and health related services for people with low income in the United States. Because incarcerated populations are overwhelmingly low income, this means that jails and prisons are excluded from accessing this source of funding to provide healthcare for their occupants.
- Counties and cities pay for almost all healthcare provided to inmates in local jails.
- States pay for almost all healthcare provided to inmates in state prisons.
- The MIEP strips or suspends Medicaid coverage from anyone who is incarcerated, whether pre- or post-trial. As a result, anyone who was receiving Medicaid prior to incarceration has to reapply or reactivate Medicaid coverage after release.[6] Some states are creating programs to address the MIEP by arranging Medicaid reapplication 90 days prior to release.[7]
- Many persons recently incarcerated have no health insurance coverage due to the MIEP.
The MIEP has pronounced effects on mental health care.
- The largest mental health providers in the United States are jails.[8]
- 44% of individuals in jails have a history of mental illness. 37% of individuals in prisons have a history of mental illness.[9]
- Many individuals with mental illness are released from jail without health insurance to access mental health care.
References
- ↑ Edmonds, Mira (Spring 2021). "The Reincorporation of Prisoners into the Body Politic: Eliminating the Medicaid Inmate Exclusion Policy". Georgetown Journal on Poverty Law and Policy. XXVIII (3): 279. Retrieved 2026-01-11.
- ↑ United States Code. 42 U.S.C. § 1396d: U.S. Government Publishing Office. 2011 Edition.
except as otherwise provided in paragraph (16), such term does not include—(A) any such payments with respect to care or services for any individual who is an inmate of a public institution (except as a patient in a medical institution); or (B) any such payments with respect to care or services for any individual who has not attained 65 years of age and who is a patient in an institution for mental diseases (except in the case of services provided under a State plan amendment described in section 1396n (l)).
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- ↑ "Medicaid Inmate Exclusion Policy (MIEP) Advocacy Toolkit". 17 February 2025. Retrieved 2025-12-10.
- ↑ "Health Coverage and Care for the Adult Criminal Justice-Involved Population". KFF. 5 September 2014.
The Medicaid Inmate Exclusion Policy. Federal Medicaid law prohibits the payment of federal Medicaid matching funds for the cost of any services provided to an "inmate of a public institution," except when the individual is a "patient in a medical institution".
- ↑ "Inmates are excluded from Medicaid – here's why it makes sense to change that".
However, individuals are ineligible for Medicaid while they are incarcerated due to a federal law known as the Medicaid Inmate Exclusion Policy (MIEP)
- ↑ Edmonds, Mira. "The Reincorporation of Prisoners into the Body Politic: Eliminating the Medicaid Inmate Exclusion Policy" (PDF).
- ↑ "Section 1115 Waiver Watch: Medicaid Pre-Release Services for People Who Are Incarcerated". KFF. 19 August 2024.
- ↑ Westervelt, Eric (25 February 2020). "America's Mental Health Crisis Hidden Behind Bars". NPR.
- ↑ "Medicaid Coverage for People Who are Incarcerated". National Alliance on Mental Illness.
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