Questions & Answers: The Affordable Care Act and County Jails

"The implementation of the Affordable Care Act (ACA) has set off reforms in health care systems across the country, including in county jails ... Many of those who cycle in and out of county jails may now be able to obtain health insurance through the Health Insurance Marketplace or expanded Medicaid. County jails are therefore in a unique position to connect those in their custody with health insurance during pretrial detention or prior to discharge. Evidence suggests this could contribute to reduced health care and criminal justice costs to the county and lower jail operating costs. This brief will answer some of the most commonly asked questions about the ACA and how it relates to county jails" (p. 1). Answers provided cover: which offenders are eligible for coverage under the ACA; whether jails can bill Marketplace insurance plans for pretrial detainees; whether jails can bill Marketplace insurance plans for sentenced inmates; whether jails can bill Medicaid for pretrial detainees or sentenced inmates; whether Medicaid or Marketplace insurance plans will pay for court-ordered services; the 10 categories of items and services that are considered Essential Health Benefits; what to do if the open enrollment period has closed for the year; the number of inmates a jail can enroll; the differences between suspending and terminating Medicaid coverage; the states that suspend rather than terminate Medicaid; whether individuals can enroll if your state did not expand Medicaid; and how you can find out what your state and county are doing to implement the ACA.