Medicaid Expansion and Criminal Justice Costs: Pre-Expansion Studies and Emerging Practices Point Toward Opportunities for States

Prepared for the Robert Wood Johnson Foundation’s State Health Reform Assistance Network

The expansion of Medicaid under the ACA in many states has generated substantial interest in the potential role that Medicaid may play in tackling pressing criminal justice issues. Recent research by Manatt Health has examined the fiscal implications of Medicaid expansion. The first and second reports explored state budget savings and revenue gains associated with expansion, while the third specifically examined the impact of expansion on uncompensated care spending and related state budget implications.

This issue brief, the fourth in this series prepared by Manatt Health, examines the potential for states to use Medicaid expansion as a tool for tackling issues at the intersection of healthcare and criminal justice, including opportunities to divert individuals with mental health or substance abuse issues from unnecessary incarceration and to reduce recidivism rates by connecting people to health coverage and appropriate, community-based care. It is based on state experiences prior to expansion, focusing on state savings associated with providing healthcare services and social support to justice-involved individuals through state-funded programs, and also highlights new strategies for connecting justice-involved individuals to coverage and care.

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