Medicaid Expansion and Mortality Among Formerly Incarcerated Individuals.

Area of Science:

• Public Health
• Health Services Research
• Criminology

Background:

• Formerly incarcerated individuals face elevated mortality risks upon community reentry.
• The Affordable Care Act's Medicaid expansion offers potential for improved health outcomes.
• Research on Medicaid expansion's impact on the formerly incarcerated population is limited.

Purpose of the Study:

• To evaluate the association between Medicaid expansion and all-cause mortality in formerly incarcerated individuals.
• To conduct stratified analyses by race and ethnicity to identify differential impacts.

Main Methods:

• Utilized a cross-sectional study design with stacked difference-in-differences (DID) analysis.
• Linked prison release data (Criminal Justice Administrative Records System) with mortality data (Numerical Identification file).
• Analyzed person-month-level data for 2,210,000 formerly incarcerated individuals across 17 states (2010-2020).

Main Results:

• Medicaid expansion was associated with a 14% reduction in monthly all-cause mortality among formerly incarcerated individuals.
• Significant reductions were observed among Black individuals (21% lower odds) and White individuals (15% lower odds).
• No significant association was found for Hispanic individuals.

Conclusions:

• Medicaid expansion is linked to decreased mortality rates for individuals post-incarceration.
• The benefits are particularly pronounced for Black and White formerly incarcerated populations.
• Findings emphasize the necessity of extending Medicaid coverage to support successful reentry and reduce health disparities.