Table 1 Role of Federal Policy in Medicaid suspension and enrollment

Inmate exclusion creates need for enrollment and suspension activities

“We’ve talked about a number of things that are quite technical that may be seeming around on the edges, but it is working around this statutory requirement, which is the payment exclusion. And so our focus becomes, how quickly can somebody get back in? How quickly can you suspend in order to comply?” —National Expert

Desire for more flexibility on Medicaid Inmate Exclusion Policy

“At the local level there are people who they see three to five times a month… Additional federal flexibilities would be really helpful there” —Medicaid Official

New 1115 Medicaid waivers will spur more better suspension and enrollment programs

“I think that if you’re a state and you’re trying to decide whether to make the investments that are needed to get people who are incarcerated, enrolled in Medicaid, the fundamental question you ask yourself is ‘what is the cost benefit analysis?’ And if you’re able to provide services to people and enhance the connections that they face at entry or reentry between health care services, I think the business case becomes much stronger and the benefits become much stronger” —National Expert

Calls to consider exemption of pre-trial detainees from Medicaid Inmate Exclusion Policy

“If somebody is still in pretrial why would you shut it off? Frankly, I think it’s an easier solution … jails barely have good data to know who’s coming in and out… it is just easier for them to just know this person you’re still pre-trial has not been charged or convicted” —National Expert