Medicaid expansion will help addicts recover

Friday, Jul. 04, 2014

Long before the Affordable Care Act debate, the Catholic Church asserted that health care is a fundamental human right. Long before the war on drugs, our Church supported efforts to provide better treatment for mental illnesses and addictions. Long before minimum mandatory sentencing became the norm, the Catholic Church fought for restorative, rather than purely retributive, justice. All of these causes are intersecting right now in Utah for many current and former inmates who have substance abuse disorders – they will go without health insurance, and thus necessary treatment, unless the state expands Medicaid.

As the PEW Research Center parses through the data regarding our state’s criminal justice system and presents it to the public, it is becoming increasingly clear that the majority of people who come into contact with the justice system have substance abuse problems (a national study found that 80 percent of female prisoners – the fastest growing group in Utah – have substance abuse problems). While the crime that lands them in prison may not have been directly related to drugs, more often than not drugs or mental illness are behind the crime. 

Mental health experts agree that addictions must be managed for the long term so that a person can reach the point of being able to recognize and respond appropriately to the triggers that lead him or her back to the addictive behavior. No 30-day treatment program will “cure” an addict’s disease. A person struggling with alcohol, drug, or other addictions needs continuous care, with levels of treatment appropriate to the person’s individual recovery stage. All such care costs money. For non-offenders, health insurance may cover much of the costs, but for ex-offenders, insurance is problematic because many private insurance companies will not cover the costs of treatment for addiction if the treatment is court ordered. This may be less of a concern, however, because most recently released prisoners will not immediately find full-time employment that provides health benefits. Rather, many will fall into the Medicaid coverage gap – ineligible for Medicaid and unable to afford private insurance. For these newly released ex-offenders, leaving prison means ending their road to recovery because they do not have access to necessary treatment for their disease.

How would Medicaid Expansion help? By providing coverage for individuals who live at or below 138 percent of the federal poverty line. Without continuous care for their mental or substance abuse disorders, offenders are more likely to relapse and re-offend – and to cost the state more money as it pays for their jail time. According to one study from Washington State, the cost of 94 days of incarceration is equal to the cost for two years of medical care for mental health or substance abuse disorders.

More importantly for Catholics, providing access to health care treatment for substance abuse problems recognizes the inherent human dignity of the addict. We should be appalled that our current system tends to treat addiction as a crime first and as a health issue secondarily, if at all. Given the numbers of individuals in prison due to addictions, it is clear that substance abuse is a public health crisis; one that Catholics should argue would best be treated by providing individuals the opportunity to recover from the disease through appropriate medical care, not through incarceration.   

Every human being, even an addict, is made in the image and likeness of God. Thus, we as Catholics must strive to protect the sanctity and dignity of the addict’s life by, among other things, supporting the expansion of Medicaid in Utah to vulnerable individuals who will otherwise be denied life-saving treatment.