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County Jails and the Affordable Care Act: Enrolling Eligible Individuals in Health Coverage

NCJ Number
Anita Cardwell
Date Published
March 2012
9 pages
This brief identifies and discusses some of the issues and challenges county jails and human services staff may face in enrolling eligible inmates in health insurance and Medicaid under the Federal Affordable Care Act (ACA).
By 2014, the ACA requires that health insurance exchanges be established in each State, and States can either opt to create and run their own exchanges or allow the Federal Government to develop and operate the exchange in the State. Exchanges are intended to be regulated insurance marketplaces where individuals without employer-sponsored health insurance will be able to obtain coverage or small businesses can obtain coverage for their employees. In 2014, the ACA also expands Medicaid eligibility to include all individuals under age 65, including adults without children, who have incomes up to 133 percent of the Federal poverty level (FPL). This brief explains how these ACA provisions will be available for eligible jail inmates, with attention to how eligibility is affected by a jail inmate's legal status (pre-adjudication or post-adjudication). The enrollment processes and procedures for newly eligible individuals are outlined, with attention to barriers related to the jail environment and jail population characteristics, information-technology challenges, and challenges associated with eligibility changes. Addressing such challenges can have the benefit of improving jail inmates' link to appropriate medical and behavioral health care services. This, in turn, can help in reducing recidivism rates. Examples of local and State practices are provided that may serve as models for counties and States as they plan for ensuring that underserved jail inmates eligible for ACA health coverage in 2014 will receive these services. 3 summary "boxes" and a listing of 3 additional resources