Alabama jail inmates’ Medicaid benefits would be preserved under new bill

Feb. 20--County jail inmates would have their Medicaid benefits suspended -- not revoked -- under a bill that the Alabama Legislature will soon consider.

The change could keep inmates with serious mental illnesses from returning to jail again and again, the bill's supporters say.

"One of the biggest problems in our jails is the revolving door of people with mental health problems," said Sen. Cam Ward, R-Alabaster, sponsor of the bill.

Ward and co-sponsor Rep. Chris England, D-Tuscaloosa, plan a press conference Tuesday to promote their bill, which would allow inmates who were on Medicaid at the time of their arrest to go back on Medicaid as soon as they're released.

Under federal law, the state-and-federal health insurance program won't pay medical bills for inmates, whether in state prisons or county jails. Alabama and most other states have historically terminated inmates' Medicaid benefits when they're admitted to jail, meaning the inmate has to apply to have them restored, a process that Ward said can take weeks.

The new bill, Ward said, would get mentally ill inmates back on their medication, or into some other form of care, as soon as they leave a county jail.

The bill wouldn't cost the state's cash-strapped Medicaid program anything. The federal government pays most of the cost of Medicaid; Ward's bill would have the counties picking up state's portion of the tab. Ward claims the counties will still save money, because Medicaid will be able to pick up medical costs for inmates if they leave jail to be admitted to a hospital.

In Calhoun County, there are about 60 people with serious mental illnesses who are chronic jail inmates, Chief Deputy John Garlick said.

Garlick worked for years as the county's mental health officer. He said the state's residential mental health facilities are about 2,000 beds short. People who need that treatment often wind up on the street until they're caught in a misdemeanor, he said.

"They should be in long-term care, because they don't do well outside of a structured environment," he said.

Garlick said he hadn't read the bill and didn't know whether the Sheriff's Office would support it. Attempts to reach Sheriff Matt Wade were not successful Monday.

The Association of County Commissions of Alabama has put the bill on its list of legislative priorities for the year. Ward sponsored a bill last year that made a similar change to Medicaid for inmates in state prisons. The bill passed both houses unanimously.

Shifting the cost of inmate medical care to the federal government could have its risks. Republicans in Congress have discussed turning Medicaid into a block grant program that gives each state a set amount of money for Medicaid and a freer hand in how that money is spent. State lawmakers still aren't sure whether that change, if it comes to pass, would leave the state with more Medicaid money or less.

Ward's bill, as well as a House version by England, are scheduled for discussion in legislative committees Wednesday.

Capitol & statewide reporter Tim Lockette: 256-294-4193. On Twitter @TLockette_Star.

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