Association for Public Policy Analysis & Management

The health needs of prisoners and the important role health plays in successful reentry has been well-documented. Overall, the prison population tends to be sicker than the general U.S. population with a number of chronic health conditions such as hypertension or diabetes—conditions that require ongoing medical management.  Recent anecdotal evidence from California counties’ early experiences with realignment suggests that the mental health care needs of the realignment population are more substantial and more serious than originally anticipated.  Research by Davis and colleagues has shown that the capacity of the mental health and drug treatment safety net for returning prisoners varies widely across California counties and that access to care varies by race/ethnicity.  Importantly, the Affordable Care Act (ACA) offers an historic opportunity to expand health insurance coverage for returning offenders and improve access to services.  This paper will estimate the mental health profiles of the different realignment populations using self-reported survey data on prisoner health care needs.  We also present the results of a methodology to estimate Medicaid eligibility under the ACA and eligibility for the tax credits for each of the offender groups.