Medi-Cal for ex-inmates

More than 100,000 people are booked into Los Angeles County’s jails each year. When they arrive, many of them are receiving healthcare benefits through Medi-Cal, the state’s healthcare program for the poor. But by the time they leave, those inmates often have no healthcare coverage.

That’s bad, and not just for the inmates but for society as a whole. When people leave jail without medical coverage, their ailments often go untreated and they wind up in the emergency room with more expensive, acute problems. The ultimate cost usually ends up being covered by taxpayers in any case because hospitals can sign them up for Medi-Cal retroactively. What’s more, former jail inmates who suffer from mental health issues and substance-abuse problems but who don’t receive treatment are more likely to end up back in jail, according to studies of jail populations in Florida and Washington.

State lawmakers have moved to address the problem by passing AB 720. The bill would allow people who are enrolled in Medi-Cal when they are sent to jail to have their benefits suspended, rather than terminated, which is what happens under current law. The legislation would also permit counties to enroll those inmates who are not covered by Medi-Cal — but who are eligible for it — while they are in jail, to take effect when they are released.

The changes are sensible and will increase the continuity of care while reducing recidivism. Currently, many people fail to re-enroll in Medi-Cal when they are released from jail, often because they are too ill, mentally or physically, to navigate the process.

The bill could also help counties save money by providing local law enforcement agencies greater flexibility in managing their jail populations, especially those inmates who are mentally ill but not considered dangerous. In L.A. County, an estimated 15% of inmates suffer from some form of mental illness, and taxpayers spend about $160 a day to house them — nearly twice the cost of housing other inmates. If more of those inmates were covered, the county might be able to release them and divert them to more effective and less costly programs.

What’s more, enrolling inmates in Medi-Cal while they are detained would allow counties to shift some costs to the federal government. Starting in 2014, the federal government will pay for 100% of the medical costs of people who are newly eligible for Medi-Cal, including for pretrial inmates who are released on home detention and required to get treatment. That’s a sensible approach that will help individuals who don’t really belong in jail get the treatment they need to stay out of jail. No doubt, that’s one reason the California State Sheriffs’ Assn. supports the measure.

We urge Gov. Jerry Brown to sign AB 720.