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At Least 35% Of People Eligible For Medicaid Expansion Are Ex-Convicts

March 11, 2014

By Avik Roy

If you listen to the President, and other supporters of Obamacare, you might get the impression that the reason why tens of millions of Americans go without health insurance is because these people have pre-existing conditions, and health insurers are too mean to cover them. The truth is quite different. Less than a million Americans lack health insurance because of a pre-existing condition. And it turns out that a good number of Americans are uninsured not because they are sick, but because they are convicted criminals.

When Obamacare was signed into law in 2010, the Congressional Budget Office estimated that half of the law’s expansion of health insurance coverage would come from expanding Medicaid, America’s government-run health insurance program for the poor. However, in 2012, the Supreme Court ruled that states could decline to expand their Medicaid programs; thus far, 25 states have held off. As the debate continues in those holdout states, one data point has gotten almost no attention.

It turns out that more than a third of the U.S. population eligible for the Medicaid expansion are ex-cons. In 2011, the U.S. Department of Justice estimated that "at least 35 percent of new Medicaid eligibles under the Affordable Care Act will have a history of criminal involvement."

They arrived at this number by noting that approximately 10 million Americans are either in jail or released from prison each year; if approximately 60 percent of these individuals are uninsured enrollees in the appropriate income range, and the Medicaid expansion was originally estimated to cover 16 million people, then more than 35 percent of the Medicaid expansion population is comprised of convicted criminals.

Yesterday, in a front-page story in the New York Times, Erica Goode described the impact of Medicaid on the prison population. Medicaid’s "most important benefit," according to corrections officials, "is that inmates who are enrolled in Medicaid while in jail or prison can have coverage after they get out. People coming out of jail or prison have disproportionately high rates of chronic diseases, especially mental illness and addictive disorders…many would qualify for Medicaid" under Obamacare’s expansion of the program.

Defenders of Obamacare’s Medicaid expansion argue that it’s a good thing that ex-convicts can get Medicaid coverage, because it might help them stay out of jail. "If they go off their medication, oftentimes it can once again lead to more criminal activity," asserted Rick Raemisch, executive director of the Colorado Department of Corrections, to Erica Goode.

Real-world data to assess this hypothesis is mixed, but it’s a hypothesis that can’t be dismissed out of hand. It’s certainly true that policy reformers of all stripes should give some thought as to how best to prevent ex-cons from returning to crime.

But Medicaid is an especially expensive, and inefficient, and ineffective program rife with waste, fraud, and abuse. You can be sure that there are plenty of taxpayers who work hard and play by the rules, who are wondering why they should pay more in taxes for this purpose. It’s certainly not what they were told they were paying for when Obamacare was passed.

Original Source:



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