Supervisors Push To End Medicaid Suspension For Incarcerated

Milwaukee County Jail. Photo by Jeramey Jannene.

Being arrested, but not convicted of a crime, can sever someone’s connection to health care, and members of the Milwaukee County Board are calling on the federal government to change that.

Under federal law, Medicaid cannot cover health care expenses for someone who is incarcerated. In Wisconsin, this historically meant anyone incarcerated in a prison, or even detained in a jail awaiting trial, lost their Badger Care.

In 2020, with the onset of the COVID-19 pandemic, the state changed its policy for individuals who were detained in jail but not convicted of a crime. Health care benefits would no longer be terminated, instead suspended. The difference means losing coverage, but not losing enrollment in Badger Care. However, the individual must still file a report with the state once they are out to resume coverage.

Sup. Justin Bielinski has sponsored a resolution that would direct the county’s lobbyists to request a change in federal law allowing anyone incarcerated pre-trial to keep their health care coverage. The resolution already has co-sponsorship from six other supervisors: Anne O’Connor, Sky Capriolo, Caroline Gómez-Tom, Sequanna Taylor, Juan Miguel Martinez and Steven Shea.

The state’s policy change four years ago was aimed at improving health care access and easing re-entry to the community. The same logic applies to this resolution, only supervisors want to see federal policy changed to ensure that no one loses any access to health care simply because they were arrested and detained in jail without being convicted of a crime.

“Pretrial detention or involvement in the criminal justice system disproportionately affects individuals from marginalized communities, particularly low-income and communities of color, and the loss of federal health care benefits exacerbates existing inequities in access to essential health services,” Bielinski’s resolution states.

Maintaining Medicaid would help the county fulfill its responsibility to meet the health and medical needs of the people it detains, Bielinski said. Federal legislation like the Due Process Continuity of Care Act — introduced in the U.S. Senate in 2023 — could increase the resources the county has to do this, he said. The bill, which maintains federal healthcare coverage for people being detained pre-trial, has not yet had a hearing.

“With the jail’s medical provider Wellpath undergoing Chapter 11 Bankruptcy proceedings, Milwaukee County needs to keep its options open,” Bielinski said. “Allowing Medicaid reimbursement for pretrial medical services could provide the funds necessary to in-house these services in future years, improving local accountability in the process.”

The policy Bielinski is pushing is also supported by the National Association of Counties and the National Sheriff’s Association. Academics, advocacy groups and elected officials have also argued for eliminating the Medicaid exclusion for incarcerated individuals altogether.

From the view of the federal budget, eliminating the exclusion or the suspension would mean the federal government is paying matching funds to state Medicaid plans — like Badger Care in Wisconsin — at the same time that states are already providing health care services to individuals while they are incarcerated.

In 2023, Sen. Tammy Baldwin introduced the Reentry Act of 2023, which would have eliminated all Medicaid exclusions during the final 30 days of incarceration. The bill has not gotten a hearing.

“Reinstating federal health care benefits for non-convicted individuals involved in the Milwaukee County justice system would enhance public safety by promoting continuity of care, supporting mental health and substance use treatment, and facilitating successful reintegration into society, thereby reducing recidivism rates,” according to Bielinski’s resolution, headed for the board in December.

Update: This story was updated to include additional information from Sup. Justin Bielinski.