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California Approved to Offer Medicaid Benefits to Justice-Involved Individuals Prior to Release

Updated: Feb 13, 2023

For the first time, justice-involved individuals will be eligible to receive critical health care coverage through Medicaid prior to their release from jail or prison as part of an ongoing effort by the Biden-Harris Administration to expand access to health care. The US Department of Health and Human Services (HHS) approved the section 1115 waiver in California in late January.

Under the demonstration project, Medicaid beneficiaries in California will be able to secure coverage for critical health care services such as substance use disorder treatment, behavioral health services, and treatment for chronic health conditions such as diabetes and hypertension before they are released from jail, prison or a youth-correctional facility. Also, the person can be connected to community-based Medicaid providers 90 days prior to their release to ensure their treatment will continue after they return to the community.

“This is a game changer for providing addiction treatment services during reentry,” said Jessica Hulsey, Founder and Executive Director of Addiction Policy Forum. “We know that the time period immediately after release from incarceration is the most dangerous time for individuals with a substance use disorder to overdose. This demonstration will ensure the continuity of care that could make the difference in saving lives.”

HHS Secretary Xavier Becerra said in a press release, “In partnership with HHS, the state of California is leading the way in providing coverage to justice-involved individuals. This is the first time in history Medicaid will be providing coverage to justice-involved individuals before they’re released. It is a step forward in closing gaps in services this underserved community experiences, and I encourage other states to follow California’s lead.”

What is a Section 1115 Waiver?

Under Section 1115 of the Social Security Act, a state may seek a waiver from the US Secretary of Health and Human Services to expand services to specific groups of people consistent with the goals of Medicaid and the Children’s Health Insurance Program (CHIP). Under this authority, the Secretary can set aside certain provisions of the Medicaid law to give states additional flexibility to design and improve their programs. Section 1115 Waivers from states can focus on many different areas, including substance use disorders.


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