States Could Not Terminate Medicaid for Juveniles in Custody Under Bill


WASHINGTON — States would be prohibited from terminating Medicaid coverage for incarcerated juveniles under legislation introduced today in the House and Senate.

States could suspend coverage while juveniles were in custody rather than cutting off their coverage, a change the bill’s sponsors said would ensure a smooth transition for youth as they re-enter the community.

States would be required to automatically restore Medicaid enrollment when a juvenile was released.

Many juveniles rely on Medicaid coverage for physical and behavioral health care. The National Conference of State Legislatures estimates that as many as 70 percent of children in the juvenile justice system suffer from a mental disorder.

Federal law prohibits states from drawing down Medicaid funding for people who are incarcerated. Some states, though not all, already suspend rather than terminate coverage for juveniles.

“We as legislators have an opportunity to flip the switch and make sure health coverage does not get taken away from children who need it most. The positive impacts of automatically reinstating coverage for children post detention far outweigh the negatives,” said Rep. Tony Cárdenas, D-California, a sponsor of the bill, in a news release.

Cárdenas sponsored the “At-Risk Youth Medicaid Protection Act” along with Rep. Morgan Griffith, R-Virginia. Sens. Cory Booker, D-New Jersey; and Chris Murphy, D-Connecticut introduced a version in the Senate. The bill was first introduced in 2014.

“If kids are incarcerated, they need their medication when they come out. But many states block them from getting the medication and treatment they need. The easiest way to guarantee that a kid will be locked up again is to deny him the medication needed to live a normal, productive life,” Murphy said in a news release.

The federal Centers for Medicare & Medicaid Services previously has encouraged states to suspend rather than terminate Medicaid coverage for juveniles. The states have reported some barriers to doing so, such as problems with their information management system, according to a 2014 report from the National Academy for State Health Policy.

The bill’s supporters include the National Disability Rights Network, the National Juvenile Justice Network and the Robert F. Kennedy National Resource Center for Juvenile Justice.

Jenny Collier, project director for the Robert F. Kennedy Juvenile Justice Collaborative, said the bill would ensure incarcerated young people have access to medical and behavioral health services as soon as they leave a facility.

“Access to such care and treatment will help to support more successful reentry, which is good for kids, communities, and our nation,” Collier said in an e-mail.

The Health and Human Services Department also released guidance today that clarifies that individuals who are on probation, parole or in home confinement are not considered inmates of a public institution and federal Medicaid dollars can be used for their care. The guidance also extends Medicaid eligibility to people living in community halfway houses.


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