,i  #aaeth ,,congress  #b;d ,session    
,h4 ,r4 #fgfd  ,,in ,,the ,,house ,,of  
,,representatives  ,september #aj1      
#bjah,ms4 ,kuster of ,new ,hampshire    
7for herself1 ,mr4 ,carson of ,indiana1 
,mr4 ,ryan of ,ohio1 ,ms4 ,bass1 and    
,mr4 ,cicilline7 introduced the         
following bill2 which was referred to   
the ,committee on ,energy and ,commerce 
,a ,,bill  ,to amend title ,,xix of the 
,social ,security ,act to provide a     
consistent standard of health care to   
the incarcerated4  #a4 ,short title     
,this ,act may be cited as the ,humane  
,correctional ,health ,care ,act4  #b4  
,findings ,congress finds the following3
  7#a7 ,according to the ,bureau of     
,justice ,statistics1 since #aife1 the  
,u4,s4 inmate population has grown by   
#fej percent3 from approximately        
#bjj1jjj to #a4e million inmates4  7#b7 
,prison and jail health care is         
currently the responsibility of the     
,states1 counties1 and cities4 ,a study 
by the ,pew ,charitable ,trust          

determined that health care spending in 
the prison system has grown             
substantially over the past several     
decades1 driven largely by litigation1  
and amounted to #h4a billion in #bjae4  
,prison health care spending varies     
dramatically from ,state to ,state1 but 
inconsistent approaches to quality      
measurement and monitoring make         
interstate comparison of the quality of 
care not possible4  7#c7 ,research      
published by the ,national ,institutes  
of ,health found that jail and prison   
inmates have a higher occurrence of most
 chronic medical conditions than the    
general population4  7#d7 ,according to 
the ,university of ,pennsylvania ,public
 ,policy ,center1 the quality of prison 
health care is generally known to be    
poor1 has no standard of care 7level at 
which the average1 prudent provider in a
 given community would practice71 and   
has been the subject of numerous        
lawsuits4  7#e7 ,the ,bureau of ,justice
 ,statistics reports that #cg percent of

 prisoners have a mental health         
disorder1 yet only approximately a third
 of those receive treatment4  7#f7 ,the 
,national ,center for ,addiction and    
,substance ,abuse at ,columbia          
,university estimates #fe percent of    
individuals in prisons or jails meet the
 clinical criteria for substance use    
disorder 7,,sud71 yet the use of        
,medical ,assisted ,treatment 7,,mat7   
for those with ,,sud is limited4 ,there 
is currently no mechanism to pay for    
sustained ,,mat in the criminal justice 
system4  7#g7 ,president ,trump has     
endorsed the goal of making addiction   
treatment available to those in prison4 
7#h7 ,a study published in the          
,international ,journal of ,law and     
,psychiatry states that #fh percent of  
untreated ,,sud and dual diagnosis      
7,,sud and mental disorder7 offenders   
returned to prison with an average      
annual cost of incarceration of #ca1igg4
  7#i7 ,with a repeal of the ,medicaid  
inmate exclusion1 nearly all inmates    

would be eligible for the ,medicaid     
program in ,states that expanded        
,medicaid through the ,patient          
,protection and ,affordable ,care ,act2 
thus1 ,medicaid could provide a         
sustained mechanism to pay for ,,mat1   
mental health treatment1 and general    
health care for a large portion of the  
incarcerated population4  #c4 ,repeal of
 ,medicaid inmate exclusion ,section    
#aije7;a7 of the ,social ,security ,act 
7#db ,u4,s4,c4 #acif;d7a77 is amended1  
in the matter following paragraph 7#bi71
 by striking such term does not         
include-- and all that follows through  
who is a patient in an institution for  
mental diseases4 and inserting such term
 does not include any such payments with
 respect to care or services for any    
individual who has not attained #fe     
years of age and who is a patient in an 
institution for mental diseases44