[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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