Vermont approved to expand Medicaid coverage for people transitioning out of prison

On Tuesday, Vermont joined a small list of states approved to bill Medicaid for some prison health care coverage.

“We were expecting this, but it’s definitely very exciting,” said Isaac Dayno, chief of staff for the Vermont Department of Corrections. “Now comes the hard work of designing our implementation plan.”

The approval arrived through Vermont’s Medicaid waiver, a process through which the federal government approves expanded Medicaid coverage for experimental or innovative projects. Vermont is now among nine states approved for the prison health care expansion, and Dayno said Vermont is aiming to launch the increased coverage in 2026.

The expansion, approved by the U.S. Department of Health and Human Services’ Centers for Medicare & Medicaid Services, would allow sentenced, incarcerated people in Vermont to access Medicaid during the 90 days before their release. That coverage, advocates say, would provide a more seamless transition back into the community.

The change marks a “huge shift,” Dayno said.

Prison officials and reform advocates say the Medicaid exclusion can lead to a gap in health care coverage when people are released from prison — a vulnerable period during which the formerly incarcerated are anywhere from 10 to more than 100 times more likely than their peers to die of a drug overdose.

“For people involved in the justice system, ensuring a successful transition back into the community includes having the health care supports and services they need,” U.S. Health and Human Services Secretary Xavier Becerra said in a statement announcing the expansion. “I’m pleased to see more and more states putting resources behind efforts that will ensure these individuals have what they need to thrive.”

Incarcerated people have been ineligible for Medicaid since the federally funded health care program was signed into law in 1965. Currently, Vermont has relied on a manual, clunky process — due in large part to outdated IT — to enroll people in Medicaid when they exit prison.

Now, the Vermont Department of Corrections and the Department of Vermont Health Access, among other arms of state government, plan to spend the next year and half designing a new system, according to Dayno. He said “care managers” from the Vermont Chronic Care Initiative would likely help manage medical care for a person’s reentry under the future program.

In addition to better care, the state also expects to save money.

Medicaid is “a very cost-efficient system as opposed to private, for-profit health care, which corrections systems have relied on,” Dayno said. The federal government requires that a state reinvest its savings through the waiver back into the system.

While he acknowledged that many of the details and technical aspects of the program are still to come, the announcement, he said, was cause for celebration.

“At the end of the day, I think this is going to save lives,” Dayno said.

Read the story on VTDigger here: Vermont approved to expand Medicaid coverage for people transitioning out of prison .