[Congressional Record Volume 164, Number 102 (Tuesday, June 19, 2018)]
[House]
[Pages H5233-H5234]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          MEDICAID REENTRY ACT

  Mr. WALDEN. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 4005) to amend title XIX of the Social Security Act to allow 
for medical assistance under Medicaid for inmates during the 30-day 
period preceding release from a public institution, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 4005

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Medicaid Reentry Act''.

     SEC. 2. PROMOTING STATE INNOVATIONS TO EASE TRANSITIONS 
                   INTEGRATION TO THE COMMUNITY FOR CERTAIN 
                   INDIVIDUALS.

       (a) Stakeholder Group Development of Best Practices; 
     Medicaid Innovation Accelerator Program.--
       (1) Stakeholder group best practices.--Not later than 6 
     months after the date of the enactment of this Act, the 
     Secretary of Health and Human Services shall convene a 
     stakeholder group of representatives of managed care 
     organizations, Medicaid beneficiaries, health care providers, 
     the National Association of Medicaid Directors, and other 
     relevant representatives from local, State, and Federal jail 
     and prison systems to develop best practices (and submit to 
     the Secretary and Congress a report on such best practices) 
     for States--
       (A) to ease the health care-related transition of an 
     individual who is an inmate of a public institution from the 
     public institution to the community, including best practices 
     for ensuring continuity of health insurance coverage or 
     coverage under the State Medicaid plan under title XIX of the 
     Social Security Act, as applicable, and relevant social 
     services; and
       (B) to carry out, with respect to such an individual, such 
     health care-related transition not later than 30 days after 
     such individual is released from the public institution.
       (2) State medicaid program innovation.--The Secretary of 
     Health and Human Services shall work with States on 
     innovative strategies to help individuals who are inmates of 
     public institutions and otherwise eligible for medical 
     assistance under the Medicaid program under title XIX of the 
     Social Security Act transition, with respect to enrollment 
     for medical assistance under such program, seamlessly to the 
     community.
       (b) Guidance on Innovative Service Delivery Systems 
     Demonstration Project Opportunities.--Not later than one year 
     after the date of the enactment of this Act, the Secretary of 
     Health and Human Services, through the Administrator of the 
     Centers for Medicare & Medicaid Services, shall issue a State 
     Medicaid Director letter, based on best practices developed 
     under subsection (a)(1), regarding opportunities to design 
     demonstration projects under section 1115 of the Social 
     Security Act (42 U.S.C. 1315) to improve care transitions for 
     certain individuals who are soon-to-be former inmates of a 
     public institution and who are otherwise eligible to receive 
     medical assistance under title XIX of such Act, including 
     systems for, with respect to a period (not to exceed 30 days) 
     immediately prior to the day on which such individuals are 
     expected to be released from such institution--
       (1) providing assistance and education for enrollment under 
     a State plan under the Medicaid program under title XIX of 
     such Act for such individuals during such period; and
       (2) providing health care services for such individuals 
     during such period.
       (c) Rule of Construction.--Nothing under title XIX of the 
     Social Security Act or any other provision of law precludes a 
     State from reclassifying or suspending (rather than 
     terminating) eligibility of an individual for medical 
     assistance under title XIX of the Social Security Act while 
     such individual is an inmate of a public institution.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Oregon (Mr. Walden) and the gentleman from Massachusetts (Mr. Kennedy) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Oregon.


                             General Leave

  Mr. WALDEN. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days to revise and extend their remarks and insert 
extraneous materials in the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Oregon?
  There was no objection.
  Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, this bill, sponsored by Representative Tonko of New 
York, Representative Turner of Ohio, and myself, requires the Secretary 
of Health and Human Services to convene a stakeholder group that will 
publish a report on best practices for how States can address the 
health considerations of incarcerated individuals as they transition 
back in our communities.
  Mr. Speaker, the Kaiser Family Foundation reports that, in States 
such as Connecticut and Massachusetts, 60 to 70 percent of inmates are 
eligible for enrollment in Medicaid upon release.
  According to 2002 data from the Department of Justice, about 68 
percent of incarcerated individuals met the criteria for substance 
dependence or abuse.
  This bill requires CMS to issue best practices for improving 
transitions back to the community, including systems for enrollment 
support, substance use treatment, and related services for individuals 
who are inmates of a public institution and who are eligible for 
Medicaid, and CMS has to do that within a year after this bill is 
enacted.
  These best practices should help both Congress and the States get a 
handle on how to help these incarcerated individuals get back on their 
feet. That is our goal.
  Mr. Speaker, my thanks to Mr. Tonko for his leadership on this issue, 
and I reserve the balance of my time.
  Mr. KENNEDY. Mr. Speaker, I yield such time as he may consume to the 
gentleman from New York (Mr. Tonko).
  Mr. TONKO. Mr. Speaker, I thank the gentleman from Massachusetts for 
yielding.

[[Page H5234]]

  Mr. Speaker, I rise in strong support of the Medicaid Reentry Act, 
and I urge all Members to support its swift passage in the House.
  This bill is about saving lives, pure and simple. 64,000 Americans 
died of a drug overdose in 2016, more than were lost at the peak of the 
HIV/AIDS crisis. Based on data from the States, we can estimate that as 
many as 10,000 of those deaths annually are individuals who have had 
some interaction with the criminal justice system in the previous year. 
This is a national emergency that demands immediate action.
  Individuals who are returning to society after a stay in a 
corrections facility are particularly vulnerable to overdose deaths. 
Research has found that formerly incarcerated individuals reentering 
society are 129 times more likely to die of an overdose during their 
first 2 weeks back into the community than the general population.
  The risk of overdose is elevated during this period due to reduced 
physiological tolerance for opioids among the incarcerated population, 
a lack of effective addiction treatment options while incarcerated, and 
perhaps poor care transitions back into their given community.
  According to the Bureau of Justice Statistics, roughly 60 percent of 
our incarcerated population has a substance use disorder, yet only 
around one-quarter of those are receiving any type of treatment.
  Even for those receiving treatment, out of the roughly 5,000 jails 
and prisons in our country, fewer than 40 provide medication-assisted 
addiction treatment using methadone or buprenorphine, which, along with 
naltrexone, is considered the gold standard in treating opioid use 
disorder.

                              {time}  1445

  Those that do offer full-scale MAT services are seeing results. I 
have seen firsthand the success of a MAT program called SHARP at the 
Albany County Correctional Facility in upstate New York where 
individuals shared anecdotes with me about how access to treatment has 
transformed their lives for the better.
  We have seen even more compelling data from the State of Rhode 
Island, where a comprehensive addiction treatment program offering 
access to all FDA-approved forms of medication-assisted treatment in 
State corrections facilities was able to lower deaths in the first year 
post-release by a staggering 61 percent.
  My legislation would open the door to more of these success stories 
and is designed to increase State flexibility in the Medicaid program 
to address the vulnerable population during the 30 days prior to an 
individual's release.
  As amended, the Medicaid Reentry Act would require the Secretary of 
Health and Human Services to release guidance to State Medicaid 
Directors on demonstration opportunities that would allow States to 
waive the current Medicaid inmate payment restriction during this 
prerelease period so that individuals could better access mental health 
and addiction care and have an improved care transition back into the 
community.
  By passing this bill, we can allow States to expand innovative 
approaches to reentry that are already underway in places such as New 
York, Ohio, New Mexico, and Rhode Island.
  I thank Energy and Commerce Chair  Greg Walden and Ranking Member 
Pallone and their staffs for the constructive collaboration on this 
bill. I also thank my Republican colleague Representative Mike Turner 
for his efforts to help shine a light on this vulnerable population.
  In closing, Mr. Speaker, while I would have liked to have gone even 
further with this effort, I believe that this smart-on-crime 
legislation will plant the seeds for meaningful change and will help to 
give individuals reentering society a fighting chance to live a 
healthier, drug-free life.
  Mr. Speaker, I urge my colleagues to support this legislation.
  Mr. WALDEN. Mr. Speaker, I have no other speakers, and I reserve the 
balance of my time.
  Mr. KENNEDY. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, I also endorse H.R. 4005, the Medicaid Reentry Act.
  One particularly vulnerable population for overdose is individuals 
reentering society post-incarceration. Incarcerated individuals, as my 
colleague, Mr. Tonko, indicated, are far more likely to suffer from 
substance use disorder. And without proper transition planning and 
treatment, former inmates are at extremely high risk of dying from an 
overdose after release. This legislation seeks to get at that problem.
  Mr. Speaker, over the course of the hearings we have had on all of 
these bills, there has not been a more dedicated, poignant, or powerful 
speaker than Mr. Tonko. This is an issue that he cares passionately 
about and that he has dedicated much of his time in Congress 
addressing. He has put that effort into text in this bill.
  Mr. Speaker, I urge the House to adopt it, and I yield back the 
balance of my time.
  Mr. WALDEN. Mr. Speaker, I have no further speakers on this bill. I 
support it and encourage our colleagues to do the same.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Oregon (Mr. Walden) that the House suspend the rules and 
pass the bill, H.R. 4005, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  The title of the bill was amended so as to read: ``A bill to promote 
State innovations to ease transitions to the community for individuals 
who are inmates of a public institution and eligible for medical 
assistance under the Medicaid program.''.
  A motion to reconsider was laid on the table.

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