Incarceration affects health care

The effects of the United States’ high incarceration rate are spilling over into health care, affecting those who have and do not have insurance.

Professor Jason Schnittker from the University of Pennsylvania addressed the issue and its consequences at yesterday’s “Brown Bag Seminar Series” held at Institute for Health, Health Care Policy and Aging Research.

He said as rates of incarceration rise, so does the chance that ex-convicts will not obtain health insurance.

“Incarceration increases your chances of being uninsured,” he said. “Un-insurance rates also affect women and children who are married to an incarcerated man.”

The United States incarcerates 1 in every 100 citizens on a daily basis, Schnittker said, but most who are incarcerated do not serve long sentences.

Rates were broken down by felony and incarceration, showing the difference between those in jail and those who were in community supervision between 1980 and 2010, Schnittker said.

“We put a very small number of people behind bars for life. Most stay there for a very short time,” he said.

Most ex-inmates face difficulties when attempting to rejoin the workforce. Since employers often provide health insurance for their workers, the service is more inaccessible to ex-convicts, Schnittker said.

“Some prisons will impress upon inmates about looking into getting health care to take care of a drug addiction, mental illness or whatever the case may be,” he said. “Many inmates are informed about the importance of public benefits prior to release, but enrollment barriers remain.”

Upon entering the correctional system, inmates lose whatever government-provided health benefits they may have, like Medicaid, Schnittker said.

“One of the ways to reduce spillover effects is to suspend Medicaid rather than terminating it upon entry into prison,” he said.

Schnittker said the Affordable Healthcare Act will improve an ex-inmate’s chances of obtaining insurance, but the system is not perfect.

“With the [AHA], 33 percent could enroll in Medicaid,” he said. “Twenty-four percent could receive tax credits to purchase insurance.”

Incarceration also takes a toll on other aspects of life, Schnittker said.

“Many states disenfranchise felons, and do not allow them to vote,” he said. “Incarceration also raises unemployment by reducing job prospects.”

Different parts of the country treat incarceration and felony convictions differently. Florida and Texas have high incarceration rates, he said. But New England has low rates.

Schnittker said Minnesota is an example of a more progressive state in terms of felon sentencing.

“I love Minnesota. They have a much higher rate of community supervision than incarceration,” he said. “The problem is that when potential employers look at a candidate, they see the felony, not whether or not the person served jail time. There is a negative stigma around them.”

Schnittker said ex-inmates’ difficulty in obtaining health insurance affects the public as a whole. When uninsured ex-inmates enter the emergency room, taxes pay for their expenditures.

“Spillover effects of un-insurance will place the burden of financing care from the uninsured on the consumer,” he said. “The effects are felt [by everyone].”

Dorothy Gaboda, the associate director for data analysis at the Center for State Health Policy, said she realized the impact this problem has on the health care system.

“The fact that [a few people] can have consequences on the rest of the public,” she said. “There are other ways that the system has changed.”

Michele Siegel, a research assistant at the institute, said she learned something new from the presentation.

“It was interesting,” she said. “Prison rates can affect other communities.”