There are many questions that are asked in legislative meetings and many times the staff notes that they will have to follow up with those questions at a later meeting. Some of these questions were answered at the March Joint Legislative Oversight Committee on Justice and Public Safety meeting. At a prior meeting a question was brought up about why the prison population is declining but the cost of health care is rising. While some questions are answered, others leave you asking more questions about what exactly is going on with the health expenditures in our prison system.
First, there was another question that needed to be answered: Can prisoners use private insurance to cover their health care costs? According to the Fiscal Research Division the answer was:
Staff attorneys are not aware of any state or federal law prohibiting the use of private insurance for prisoners. However, it appears that most employer plans and individual insurance companies drop coverage when someone is incarcerated.
The State Health Plan (SHP) does continue to cover state employee retirees who are incarcerated, as well as dependents who remain on an employee’s plan. (Presumably, state employees who are incarcerated would lose their job and subsequently, their coverage.) Coverage is only provided for services outside a DPS facility. In these cases, the SHP would be the primary insurer and DPS would be the secondary insurer. The usual SHP eligibility rules would continue to apply, so if you were only eligible because you were a state employee and you lose your state job when convicted then you would no longer be eligible (except possibly for COBRA coverage).
So in other words if you work for the state and are incarcerated, you lose your coverage but the state’s insurance plan will cover someone if they are retired. This leaves more questions about what is going on with our prison budget.
Another topic of discussion was the cost of health care in the prisons. The United States Supreme Court has held that prisoners have a constitutional right to receive necessary medical care while in custody. (City of Revere v. Massachusetts General Hospital, 463 U.S. 239 (1983).) The question is not whether the ruling was a good decision but whether a prisoner’s health care is easier to get and cheaper than a law-abiding citizens. And we need to also look at why the number of prisoners is declining but the budget is continuing to grow.
The overall Prisons Budget for 2012-2013 was $1.1 billion; 21 percent ($236,089,490) of the budget was spent on health, which includes dental and mental health. There is an additional 6 percent ($69,555,958) spent on programs that include substance abuse in-prison treatment, and academic and corrective programs. The authorized budget item for 2013-2014 is $242,349,751. While the budget has increased, the number of prisoners is on the decline, and the number of inmate hospital admissions is declining. Which brings us back to: Why is the budget growing?
There are questions about how much money is spent on each prisoner, how much they pay out of pocket, and who pays for the medical coverage that we give to prisoners. The Joint Legislative Oversight Committee on Justice and Public Safety is still looking for answers.