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How Prisoners Are Reigniting the Debate Over Texas Medicaid Expansion

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Nick Cowie for Texas Tribune
The debate over Medicaid expansion in Texas came up at the Capitol at a hearing on May 29, 2014, because of concern over rising costs of inmates' health care.

The debate over Medicaid expansion in Texas came up at the Capitol today in a new way: there’s concern about how to pay the rising costs of health care for prison inmates.

Costs related to infectious diseases like Hepatitis C and HIV are on the rise in the Texas correctional system. Another number on the rise: the amount of Texas inmates older than age 55.

State Rep. Sylvester Turner, D-Houston, says it’s another reason why the state should consider expanding Medicaid eligibility as offered by the Affordable Care Act.

"I think we do have to answer to taxpayers as to why we are paying nearly $1 billion dollars in [General Revenue] of their money on the Correctional Managed Care System, when we could draw down $240 million and save Texans some money," Rep. Turner said.

But the Texas Department of Criminal Justice chief Brad Livingston says the $240 million estimate isn't so clear. Federal dollars for Medicaid can’t be used in secure facilities, so the money would only apply to inmates treated in hospitals, and therefore the amount could be less.

Experts say part of the solution to the spread of infectious diseases among inmates may be more education, which has been effective in containing HIV infections in prison facilities.

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