The importance of connecting justice-involved populations to health coverage and care is evident from the high levels of physical and behavioral health issues they experience. Compared with the general population, people in prisons have four times the rate of active tuberculosis, nine to ten times the rate of hepatitis C, eight to nine times the rate of human immunodeficiency virus infection, three times the rate of serious mental illness and four times the rate of substance abuse disorders.

With support from the Department of Justice’s Bureau of Justice Assistance, Manatt Health and the Urban Institute developed a policy guide for state and local justice and healthcare officials to increase Medicaid and health insurance coverage for justice-involved populations to improve health outcomes, enhance public safety, reduce recidivism and more efficiently use public resources. This comprehensive guide presents a menu of practical strategies for optimizing enrollment in health insurance coverage, supporting coordinated systems of care, and leveraging various funding streams to sustain state and local activities. The strategies highlighted in the guide are informed by tested approaches implemented by states and localities across the country.