U.S. Government Accountability Office (GAO)

"Financing health care for inmates can be a significant portion of state correctional spending for some states with health care costs ranging from an estimated 6 percent to 33 percent of institutional corrections spending in 2008, the most recent estimate available. The combination of expanded Medicaid eligibility and enhanced funding for those newly eligible as allowed under PPACA [Patient Protection and Affordable Care Act] gives states additional incentives to enroll inmates in Medicaid and obtain federal matching funds, and increases the federal responsibility for financing allowable services for inmates. Questions exist about the potential costs to the federal government, because little is known about how many inmates are eligible for Medicaid or the extent to which states are obtaining federal matching funds for allowable services ... In this report, we provide information on the proportion of inmates eligible for Medicaid, and state efforts to enroll inmates in Medicaid and obtain federal matching funds for allowable services" (p. 2). While a large percentage of inmates will be eligible for Medicaid in the 27 states that have expanded Medicaid eligibility, only a very small percentage will be eligible for federal Medicaid funds. The impact to federal spending will be extremely limited.