Maximizing the Opportunities of the Affordable Care Act for Justice-Involved Individuals

Background There are nearly seven million people involved with the criminal justice system in the United States: individuals who have either been in jail or prison, or who are on probation or parole. Prior to the Affordable Care Act (ACA), members of this population – many of whom suffer from substantial substance use disorders, mental health issues, and chronic health conditions – had little to no health insurance coverage. In many states, the ACA expands Medicaid eligibility to extremely low-income people (household income up to 138 percent of the federal poverty line). Consequently, many people who are involved with the criminal justice system will now be eligible for Medicaid coverage. As a result of expanded eligibility for Medicaid, many justice-involved people will now have better health coverage, access to community-based care, and improved continuity of care for their various health needs. Access to regular health care is essential to the successful release of justice-involved individuals into their communities. Without it, they are at greater risk of recidivism and returning to jail or prison. There are also positive implications for public health, public safety, and state and local correctional and health agencies that provide significant funding for health care for justice-involved people. There is also an opportunity for court and corrections administrators to enroll and connect this population with health care services available through the ACA at various intercepts, such as arrest, pretrial, and reentry. To assist in this effort, the Bureau of Justice Assistance (BJA) awarded funding to the Legal Action Center (LAC) in October 2013 to help criminal justice stakeholders understand, implement, and maximize access to ACA resources for justice-involved individuals. Advocates for Human Potential (AHP) and Treatment Alternatives for Safe Communities (TASC) of Illinois are partners in this project with LAC. Summary of LAC’s Training and Technical Assistance As part of its training and technical assistance project, LAC is currently working to complete a review of materials and resources on ACA-related topics most important to criminal justice stakeholders. They are reviewing general government policy and research materials on the ACA, as well as key topics related to financing health coverage for justice-involved individuals through Medicaid and private insurance, benefits, and access to care. Once completed, the materials identified in the landscape review will be made available to the criminal justice stakeholders. LAC is also working to create additional informational materials related to health insurance coverage of and access to care for justice-involved individuals in response to needs identified by a number of BJA's training and technical assistance (TTA) providers. BJA TTA providers want to learn how criminal justice stakeholders can enroll these individuals in health insurance at all intercepts of the justice system. Providers also want to know which mental health and substance use disorder services are covered by various states’ Medicaid benefits, and the implications of treatment services being court-ordered on reimbursement. LAC is working to identify existing materials and to create new, straightforward tools and materials to support stakeholders’ work in these areas. In the coming months, LAC will conduct workshops and presentations on topics related to health reform for members of the criminal justice field. During the Community Justice 2014 international summit, taking place April 22-24, 2014, in San Francisco, California, LAC will host breakout sessions for community courts stakeholders to help them understand the ACA and its implications for justice-involved populations. On July 18-19, 2014, in Chicago, Illinois, LAC will present at the 2014 National Workshop for Residential Substance Abuse Treatment (RSAT) to provide information to representatives of states and local governments on how the ACA can impact residential substance abuse treatment programs in their correctional and detention facilities. Both events have open registration. Criminal justice stakeholders and community health care providers are encouraged to attend to learn more about implementing the ACA in justice settings. Through developing resources and conducting trainings, LAC will help criminal justice stakeholders effectively implement health care reform. According to Gabrielle de la Guéronnière, Director for National Policy, Legal Action Center/National HIRE Network, “the health-based approaches in the ACA are a paradigm shift in viewing substance use as a health condition and present the opportunity to lower health costs, dramatically reduce the number of people involved in the criminal justice system, and improve health outcomes and overall well-being for millions of people.” LAC looks forward to working with criminal justice stakeholders to take full advantage of ACA resources to support the reintegration of justice-involved populations into their communities. For more information on LAC’s services, visit To submit the work of your organization or jurisdiction for consideration to be featured in a future BJA NTTAC TTA Spotlight, please email