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Health Reform

National health reform under the Patient Protection and Affordable Care Act (PPACA) creates opportunities to re-examine how we connect health care provided in our nation’s jails with care provided in local communities. COCHS is closely involved with federal and state agencies as they develop and implement new policies on Medicaid expansion under the PPACA.

Starting in 2014, Medicaid expansion under the PPACA will extend the prospect of health care coverage to an estimated 16 million newly eligible individuals, including the substantial population of non-violent offenders with mental illness or chemical addiction who cycle in and out of local jails. These individuals tend to have costly, complex health problems that frequently contribute to their criminal behavior.

For the first time, Medicaid expansion will support the delivery of community-based medical and behavioral health care that can reduce the use of jail beds as well as other costs to society. In preparation for Medicaid expansion, state legislators, county administrators, criminal justice leaders, the judiciary, and community advocates need to rethink the priorities of the criminal justice system in order to develop sound policies and regulations.

Since enactment of the PPACA, COCHS has facilitated a rethinking of the opportunities that the PPACA creates for the jail population, especially for people with underlying behavioral health disorders. Our efforts include the following:

  • Currently, we are working with three states – New York, Rhode Island and California – on efforts involving Medicaid expansion and local jail-involved populations.
  • During 2011, COCHS convened small working groups of experts that focused on issues related to health reform and to the provision of behavioral health care services for justice-involved populations under health reform.
  • On November 17, 2010, COCHS, with the Robert Wood Johnson Foundation and the Jacob & Valeria Langeloth Foundation, held an invitation-only meeting in Washington, DC, to address the implications of health reform the criminal justice population. More information is available on our PPACA Conference page.
  • We engage with many partners on issues concerning Medicaid expansion, including the National Association of Counties (NACo), the National Association of County Behavioral & Developmental Disability Directors, the Corporation for Supportive Housing, and the Center for Health Care Strategies.