SALT FACT SHEET

Ending Medical Co-Pays for the Incarcerated

SALT believes there must be a right to health care that protects and saves lives. At least 35 states require copayments and other fees for medical services at state prisons or county jails, according to the analysis by the Brennan Center for Criminal Justice at New York University School of Law.

In Virginia, the incarcerated who seek medical care must pay a $5.00 co-pay. Five dollars may not seem burdensome for someone being paid a living wage. However, an inmate working in Virginia only receives from $0.27 to $0.80 per hour. That’s 6.5 up to 18.5 hours of work to cover a medical co-pay. No other group of workers in America must work 18.5 hours to make a $5.00 co-payment. Eliminating co-pays for inmates in Virginia is a moral imperative.

Out-of-reach co-pays in prisons and jails have three inevitable and dangerous consequences:

First, when sick people cannot afford a co-payment to see a doctor, disease is more likely to spread to others in the facility--and into the community when people are released. This is an unnecessary threat to public health that can be avoided by abolishing co-pays for jail or prison medical co-pays.

Second, illnesses are likely to worsen as long as inmates do not see the doctor when needed, which means more aggressive (and expensive) treatment when they can no longer go without medical attention.

Third, despite a state policy not to deny healthcare to needy individuals, if co-pays are not met before service is rendered, the state creates a “tab” that the inmate must settle or leave prison with unpaid debt. This frustrates successful re-entry when leaving prison at a time when former inmates are expected to find employment and become financially self-sufficient.

Correctional agencies should not be risking the inmates, their institutions, and public health when they assume that by the time people seek care, treatment will be someone else’s problem. But medical co-pays encourage a dangerous waiting game for incarcerated people, correctional agencies, and public health, which none of us can afford.

Three states have eliminated the medical co-pay requirements for the incarcerated in order not to deter the ill from seeking needed medical care. Virginia should join these states because health care is not a privilege to be accessed only by those who can afford the expense. Health care costs should not prevent any inmate from receiving medical care that protects and saves lives, including the incarcerated. Virginia must do everything possible to remove impediments to receiving health care that protects and saves lives including the incarcerated.

Is there any other morally acceptable path forward?

October 2019