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Inmates and Medicaid

Other states are doing what Texas has declined to do.


Being arrested in Chicago for, say, drug possession or assault gets you sent to the Cook County Jail to be fingerprinted, photographed and X-rayed. You’ll also get help applying for health insurance.

At least six states and counties from Maryland to Oregon’s Multnomah are getting inmates coverage under Obamacare and its expansion of Medicaid, the federal and state health-care program for the poor. The fledgling movement would shift to the federal government some of the more than $6.5 billion in annual state costs for treating prisoners. Proponents say it also will make recidivism rarer, because inmates released with coverage are more likely to get treatment for mental illness, substance abuse and other conditions that can lead them to crime.

“When someone gets discharged from the jail and they don’t have insurance and they don’t have a plan, we can pretty much set our watch to when we’re going see them again,” said Ben Breit, a spokesman for the Cook County Sheriff’s Office.

The still-small programs could reach a vast population: At the end of 2012, almost 7 million people in the U.S. were on parole, probation, in prison or locked up in jail, according to the federal Bureau of Justice Statistics. About 13 million people are booked into county jails each year, according to the Washington-based National Association of Counties.


Medicaid expansion also enables more prisoners to have coverage when they are released. States that don’t expand it can help inmates get subsidized coverage in the insurance exchanges created under the law when they’re released.

Counties in about half the states are responsible for some level of indigent care at hospitals, so getting inmates enrolled can reduce costs, said Paul Beddoe, deputy legislative director for the National Association of Counties.

Cook County has been operating a pilot project to enroll prisoners in Medicaid since April under a federal waiver, while states including Connecticut, Illinois and Maryland and counties such as Multnomah, which includes Portland, have helped hundreds of prisoners apply for coverage under the Affordable Care Act since it took effect Jan. 1. California, Ohio, San Francisco and other jurisdictions are starting programs or considering them.

About 90 percent of inmates are uninsured, and many have never had treatment for their illness, Osher said. They have disproportionate rates of communicable and chronic diseases and behavioral disorders, he said. About 488,000 people in U.S. prisons and jails suffer from a mental illness, according to the National Alliance on Mental Illness in Arlington, Virginia.


The Ohio Department of Rehabilitation and Correction, which plans to start enrolling inmates during the next two months, expects that it will save $18 million a year on hospitalization alone, said Stu Hudson, managing director of health care and fiscal operations.

Ex-prisoners who have insurance will be more likely to get treatment that would help them avoid committing crimes that got them locked up in the first place, Hudson said.

“They’re provided good continuum of care from incarceration through their release into the community and onward,” Hudson said by phone.

We’ve discussed this before. Putting aside the considerable cost savings to the state, the potential impact on the many people that regularly intersect with the criminal justice system who have treatable mental illnesses could be huge. We could save a bunch more money just from the reduced rate of recidivism. There’s really no downside to this. Unfortunately, without a change in state leadership, there’s also no chance of it happening. I don’t really care about the day to day vicissitudes of the Governor’s race. This sort of thing is the prize I keep my eyes on.

Perry’s empty job-stealing tour continues

Sorry, Maryland.

Corndogs make bad news go down easier

All your corndogs are belong to us

Gov. Rick Perry is taking aim at Maryland and its business climate — his latest effort to lure out-of-state companies to Texas.

In a radio advertisement, Perry slams Gov. Martin O’Malley, a Democrat who is considering a presidential bid in 2016, for turning Maryland into a “tax and fee state” with “some of the highest taxes in America.”

“When you grow tired of Maryland taxes squeezing every dime out of your business, think Texas,” Perry says in the minute-long spot, according to WTOP, a local radio station that serves the Baltimore and Washington, D.C., areas.

In a statement released by O’Malley’s office, the Maryland governor touted the state’s achievements under his leadership, including a 2012 U.S. Chamber of Commerce ranking as the top state for innovation and entrepreneurship.

“Instead of engaging in PR stunts, Gov. Perry should come to Maryland to see firsthand the better choices that have led to these better results,” O’Malley’s office said in the statement.

Once again, I will observe that for all the attention Perry gets for these silly and expensive PR stunts, I’ve yet to see a single news story about a single job that has been relocated to Texas as a result. It would be nice if the mainstream media noticed that if the goal was to entice businesses to move to Texas, the effort has been a complete and unqualified flop, so far at least. If his mission was to convince other states to be more like Texas in terms of tax philosophy, that too has failed. Of course, if the goal was to force everyone to pay attention to Rick Perry, then I will concede that he has accomplished his mission. But beyond that, who cares?

One more thing: The Baltimore Sun, in addition to providing some delightful snark, mentions a few inconvenient facts that Perry will never mention:

We don’t want to alarm those secessionists out in Western Maryland who may find themselves drawn to a state whose governor thinks along the same lines, but you might have to take a bit of a pay cut in Texas. Like about 29 percent.

The Perry economic miracle, it seems, has been swell if you fancy working for low wages or if you’re not so keen on things like health benefits. (Texas: No. 1 in the rate of the uninsured! Obamacare? No, thank you!) If, however, you’re interested in actually making enough money to support your family, or avoiding bankruptcy if you get sick, you might consider looking a little closer to home.


Ah, you might ask, what good is having the nation’s highest median household income if you’re saddled with all those pesky taxes? Quite a lot, actually. According to the Tax Foundation — not what anyone would mistake for a liberal organization — Maryland’s state and local tax burden is 12th highest in the nation, and Texas’ is 45th. So, factoring in Maryland’s rate of 10.2 percent versus Texas’ 7.9 percent, a typical family could stay here and pull down $63,000 after state and local taxes, or move to Texas and make a bit over $45,000. The cost of living is higher here, according to Census Bureau estimates, but the comparison still works out in our favor.

And what do you get for the money? The best public schools in the nation, for starters. And that’s not just the product of some formula Education Week came up with, it’s also validated by scores on Advanced Placement tests and the National Assessment of Educational Progress. It’s a little cheaper to go to college here, too, according to the College Board, and the trends don’t look good for Mr. Perry. In-state tuition has gone up 18 percent there in the last five years. Here? Two percent. You’re almost twice as likely to run into someone with a post-graduate degree in Maryland as you are in Texas.

As someone once said, “Oops!”

Maryland to join the Big Ten

The dominoes have resumed falling.

Maryland is joining the Big Ten, leaving the Atlantic Coast Conference in a shocker of a move in the world of conference realignment that was driven by the school’s budget woes.

The announcement came Monday at a news conference with school President Wallace D. Loh, Big Ten Commissioner Jim Delany and athletic director Kevin Anderson.

“The membership of the Big Ten enables us to guarantee the financial sustainability of Maryland athletics for a long, long, long time,” Loh said.

Loh added that Maryland athletics has been living “paycheck to paycheck.” The school had eliminated seven sports programs earlier this year.

“The director and I are absolutely committed to begin the process to reinstate some of the teams we had to terminate,” Loh said.

Maryland will become the southernmost member of the Big Ten member starting in 2014.

“Really in the last year it’s become so obvious that major conferences are expanding outside of their regions,” Delany told the AP in an interview before Maryland’s news conference on campus in College Park. “You have multiple major conferences all in multiple regions.

“It seemed to us that there was a paradigm shift occurring around us. And therefore the question is how do you respond to that in a way that stay true to yourself, but is also only responsive not to the world you want but the world that you live in.”

And Rutgers will apparently join them, meaning the Big Ten will technically be the Big Fourteen. Connecticut is now reportedly going to join the ACC to fill Maryland’s slot, meaning that the Big East will at the very least have to redo its divisions before a single game has been played. Did you think we were done with all the conference-hopping? Yeah, me neither. Now we wait to see who’s next. Again.

Counting inmates where they’re from, not where they’re incarcerated

I’ve noted before that prisoners in Texas are considered for Census purposes to be residents of the county in which they are incarcerated, not the county where they were actually living at the time of their arrest. This tends to have a distorting effect on the real population of some smaller rural counties where state prisons are located. Via Grits, I see that the state of Maryland has now decided to change this practice so that inmates are counted as residents of their home counties. I think this is the right thing to do and if I had a magic wand to wave, I’d make that the national standard. The effect in Texas would be significant:

Prisoners disproportionately come from Texas’s largest counties. Harris County is 16.3% of the Texas population, but it supplies 21.5% of the state’s prisoners.[5] After adjusting for correctional facilities within the county, Harris County’s suffered a net loss of about 25,000 people as a result of how prisoners are counted.

Dallas County is only 10.6% of the Texas population, but it supplies 15.4% of the state’s prisoners.[6] This urban county lost almost 20,000 residents to rural prison hosting counties.

How the incarcerated are counted in Texas is of critical importance to an accurate count of Black communities. While Blacks are 11.5% of the Texas population, more than a third of the incarcerated people in the state are Black.

That was written in 2004, but I daresay the proportions are about the same today. Given the stakes for Harris and Dallas, you’d think there would be a bigger fuss about this. TAPPED has more.