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Challenges to Accessing Healthcare for the Formerly Incarcerated

The Marshall Project Apr 28, 2019
This article is deemed a must-read by one or more of our expert collaborators.
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Challenges to Accessing Healthcare for the Formerly Incarcerated Giving Compass
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Giving Compass’ Take:

• Both incarcerated individuals and the previously incarcerated do not have the benefits of health insurance, despite many politicians backing “Medicare for All” expansion policies. 

• While there have been some attempts to eliminate the inmate exclusion policy from Medicaid, it takes more funding and is challenging to implement across the prison system. Where can donors potentially provide support on this issue?

• Check out these criminal justice reforms to watch in 2019. 


Nearly 60 percent of Americans support some version of “Medicare for All,” an expansion of federally-funded health insurance to cover everybody. Rep. Alexandria Ocasio-Cortez, D-N.Y., the new face of the progressive movement, has suggested it is a moral priority, and multiple 2020 presidential candidates have made it a part of their platforms.

But no one is talking about making federal health insurance truly “for all” by extending eligibility to the 2.2 million people incarcerated in this country.

As a primary care doctor who cares for low-income people, some of whom are or have been involved in the justice system, I have dealt first-hand with the problems created by the so-called “inmate exclusion policy”—and it is devastating.

The original Social Security Act of 1935 prohibited the payment of federal dollars, either directly or via state pass-through, for services for “inmates of a public institution.” This means that federal dollars cannot be used to pay for healthcare or other services for incarcerated people in local jails or in state prisons, except when they are hospitalized for more than 24 hours in a separate healthcare facility.

This has serious implications for incarcerated people. Most of them, at the time they were incarcerated, were either already enrolled or were eligible for Medicaid, the federal health insurance program for very low-income people. Currently, 19 states terminate Medicaid coverage completely when a person goes to prison, meaning that he or she must reapply after release. (The remaining 31 states suspend coverage for varying amounts of time, requiring reactivation or reapplication.)

Incarcerated people have up to 12 times the risk of death within the first two weeks after release, and up to four times within the first year. Lack of continuity of care certainly contributes to this horrifying statistic.

Read the full article about healthcare for previously incarcerated by Ashwin Vasan at The Marshall Project.

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Learning and benchmarking are key steps towards becoming an impact giver. If you are interested in giving with impact on Public Health take a look at these selections from Giving Compass.

  • This article is deemed a must-read by one or more of our expert collaborators.
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    Jaime Yassif: How to Make an Impact for Biosecurity and Pandemic Preparedness

    Center for International Security and Cooperation program on Biosecurity and Global Health What is it? The Center for International Security and Cooperation (CISAC) at Stanford is a university-based center that does policy research and development in the international security space. Why I suggest it: I think CISAC has a comparative advantage in working on the technical aspects of biosecurity and developing new approaches to governance of dual-use bioscience and biotechnology. My view is based on the Center’s existing biosecurity staff, its ties to bioscience departments at Stanford and its location in Silicon Valley, which is a biotech industry hub. Johns Hopkins Center for Health Security What is it? The Center for Health Security (CHS) is a U.S.-based think tank that does policy research and development in biosecurity and pandemic preparedness (BPP), along with some communications and advocacy. Examples of ongoing GCBR-focused projects include a red-teaming project to improve our understanding of global catastrophic risks and a project focused on identifying technologies that could be used to reduce global catastrophic biological risks. CHS has also initiated a public discussion about GCBRs by publishing a working definition of this concept, which has started to get a little bit of traction in policy circles. Why I suggest it: Think tanks and advocacy groups can have a large impact in the BPP space by influencing and improving the use of government funds through policy research and development, acting as an independent source of accountability, and having the flexibility to work on long-term projects or politically controversial issues. They can also conduct research and develop innovative ideas that are useful to private donors, industry, and academia. Read the full article on biosecurity and pandemic preparedness by Jaime Yassif at Open Philanthropy Project


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