<figure>
 <img src="https://media.eaglewebservices.com/public/2020/1/1580497793171.jpeg" alt=" Currently, less than 1% of people in Kansas prisons are eligible for Medicaid. If the proposed expansion plan were to pass, 80% to 90% would be eligible. Nomin Ujiyediin / Kansas News Service" />
 <figcaption> Currently, less than 1% of people in Kansas prisons are eligible for Medicaid. If the proposed expansion plan were to pass, 80% to 90% would be eligible. Nomin Ujiyediin / Kansas News Service</figcaption>
 </figure>By NOMIN UJIJEDIIN <a href="https://www.kcur.org/post/how-medicaid-expansion-would-shift-cost-health-care-kansas-prisons-and-jails#stream/0">Kansas News Service</a>TOPEKA — The new Medicaid expansion bill, the product of a <a href="https://www.kcur.org/post/kansas-paves-medicaid-expansion-path-after-governor-and-top-republican-break-partisan-logjam" target="_blank">compromise</a>
 between Democratic Gov. Laura Kelly and some Republican leaders, would 
change how state prisons and county jails fund health care for 
prisoners.By expanding the types of people who can qualify for 
the program, the bill would extend Medicaid access to 80% to 90% of 
state prisoners if it passes, according to the Kansas Department of 
CorrectionsKansas is one of only <a href="https://www.kff.org/medicaid/state-indicator/states-reporting-corrections-related-medicaid-enrollment-policies-in-place-for-prisons-or-jails/?currentTimeframe=0&amp;sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D" target="_blank">seven U.S. states</a>
 that kicks people off of Medicaid when they go to prison or jail. The 
one exception is when an inmate is hospitalized for more than 24 hours. 
The DOC or county jails can apply for Medicaid funding to cover part of 
the cost if the inmate is eligible for the government health care plan.Right
 now, state prison officials say, less than 1% of Kansas state prisoners
 — fewer than 100 people — qualify for Medicaid based on the state’s <a href="http://www.kdheks.gov/hcf/Medicaid/eligibility_guidelines.html" target="_blank">restrictions</a>
 on age, income, disability status and family status. The department 
doesn’t collect data on how many people in county jails qualify.The
 new bill would allow the DOC to take advantage of Medicaid funding for 
more inmates. It also increases the share of state Medicaid costs that 
the federal government would pay.“It revolves around those current income requirements,” DOC spokeswoman Rebecca Witte said. “They would be eligible.”She said the department would save $2 million in 2022 if Medicaid expansion is passed.County
 jails also would see savings, said Jeffrey Easter, Sedgwick County 
sheriff and legislative chair for the Kansas Sheriffs’ Association. 
Sedgwick County spent about $1 million in 2018 on hospitalized inmates.He said if the bill passes, “that million dollars wouldn’t be coming out of my budget and local taxpayer money.”Data
 collected by the Kansas Sheriffs’ Association shows most county jails —
 excluding Sedgwick, Wyandotte, Johnson and Shawnee counties — spent a 
total of $6 million in 2018 on outside hospitalizations for inmates.That
 year, Shawnee County spent $770,000 on offsite medical treatment for 
jail inmates, but it didn’t have information on how much of that went to
 hospitalizations. A spokesman for the county Department of Corrections 
said the county does not apply for Medicaid coverage for any inmates.Wyandotte
 and Johnson counties did not immediately respond to a request for 
information on how much their jails spent on hospitalizations in 2018.<h2>Impact on Re-entry</h2>The
 Medicaid expansion bill would also require the Department of 
Corrections to help counties get jail inmates back on Medicaid after 
their release.Even people who go to jail for two weeks are 
kicked off the program and they don’t get back on Medicaid for three or 
four weeks after release, Easter said. For some people with mental 
illnesses, it can turn into a cycle.“For them to get any type of
 plan or medications, they’ve got to be back on Medicaid,” Easter said. 
“You see them decline, rearrested, and we (start) the process over 
again.”Currently, the Kansas Department of Health and Environment, which runs the state’s Medicaid program, <a href="https://www.kcur.org/sites/kcur/files/202001/KDHEPDF.pdf" target="_blank">contracts</a>
 with a company called Appriss to collect a daily list of people 
entering and leaving county jails. The department checks the list 
against its Medicaid database and terminates coverage until a person is 
released.On the state level, the DOC sends KDHE a monthly list 
of people in its prisons. The list is checked against the state Medicaid
 database and KASPER, the database of state prisoners, to determine 
whose Medicaid will be terminated.Before people are released, a 
special unit in the DOC processes applications for people going back on 
Medicaid. The Medicaid expansion bill would require the DOC to assist 
county jails with this process.For county and state governments, the biggest effect of <a href="https://www.pewtrusts.org/en/research-and-analysis/issue-briefs/2016/08/how-and-when-medicaid-covers-people-under-correctional-supervision" target="_blank">terminating Medicaid coverage</a>
 for incarcerated people is the time and resources needed to take people
 on and off, said Maria Schiff, a criminal justice and health care 
researcher for the nonprofit Pew Charitable Trusts.“Generating a new application is more work,” she said, “than activating a suspended one.”But
 the most dramatic impact, Schiff said, is for the people who lose their
 coverage. Once they’re released, they can struggle with navigating the 
health care system, especially if they’ve been incarcerated for many 
years.Most states that have expanded Medicaid employ re-entry 
counselors in prisons and jails who help people reapply for Medicaid 
before they’re released, Schiff said.“A person in a state prison
 doesn’t have the tools and internet connection and information and 
access to legal forms that individuals on the outside have,” she said.Proponents
 of Medicaid expansion have argued the policy will reduce recidivism. 
But it’s too early for researchers to know, Schiff said. Rhode Island, 
however, has seen a drop in substance abuse-related fatalities among the
 recently released.“It’s not the coverage alone. Because you 
don’t want these people just showing up in emergency departments,” she 
said. “You really want them getting attached to a primary care system.”Nomin
 Ujiyediin reports on criminal justice and social welfare for KCUR and 
the Kansas News Service. You can follow her on Twitter&nbsp;<a href="https://twitter.com/nominuj" target="_blank">@NominUJ</a>.

How Medicaid expansion would change health care in Kan. prisons