By: Jasmine Young
Executive Summary
Historically, Medicaid has prohibited federal payments for health care services for adults and youth who are incarcerated. This federal law is known as the “inmate exclusion.” The federal law restricting Medicaid funds from paying for Medicaid services while an individual is in a carceral setting must not be confused with Medicaid eligibility itself. In the past several years, there has been federal guidance from CMS to clarify eligibility rules for people who are incarcerated to ensure their re-entry back into the community is smooth and seamless. This factsheet will provide background information on the inmate exclusion, explain the federal eligibility and coverage rules that affect adults and youth who are incarcerated, and discuss how these rules have been implemented in California’s Medicaid program, Medi-Cal.
