Unbiased Analysis of Today's Healthcare Issues

Health Reform in California: Expanding Care to Ex-Cons?

Written By: Jason Shafrin - Sep• 15•11

One of the goals of health reform was to expand coverage to poor childless adults who previously did not qualify for Medicaid.  One unintended (or perhaps intended) consequence of this expansion is that a large number of individuals formerly convicted of crimes will be eligible for the this coverage.

Policymakers face a number of questions.  First, do these ex-offenders “deserve” coverage?  Many in the public may wonder why middle class individuals should be uninsured when the government is providing health care for ex-offenders.  On the other hand, those who served time have already paid their debt to society.  Should the be punished again by being disqualified for entitlement programs for which they are eligible?

Regardless of whether you think ex-offenders should be eligible for this Medicaid expansion, they without a doubt do have a number of medical problems which require treatment. NPR describes some of the challenges these individuals face.

According to Dr. George Pearson, “…a 45-year-old ex-convict will often have the ailments of someone 10 years older. Ex-convicts have higher rates of almost all chronic conditions, like high blood pressure, diabetes and asthma. It’s from living a hard life, to be sure, he says, but it’s also because they have common medical problems that go untreated.

‘So the hypertension becomes heart failure, the diabetes becomes diabetic neuropathy, amputation, blindness,’ Pearson says.”

One benefit of treating ex-convicts is that they can reduce the prevalence of communicable disease rates since ex-offenders are more likely to have HIV and Hepatitis C.

Having health insurance, however, does not mean that people will get the care they need.  NPR told the story of one ex-convict named Darren Thurmond.

He is thankful, he says, that he now has a regular doctor. But he’s homeless, living in his van and can’t quite figure out how he’ll get to his appointments to get his blood work checked or his prescriptions re-filled.

“Being homeless, often I have the time to do it, but I don’t have the gas to get there,” he says.

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