Legislation Introduced to Eliminate Copays for People Incarcerated in California Prisons


(From Press Release) – The ACLU of California, California Coalition for Women Prisoners, and Initiate Justice announced their support for AB 45, new legislation introduced today by Assemblymember Mark Stone (D-Monterey Bay) that will eliminate copayments for people inside California prisons.

Our organizations have been tireless advocates for people inside California prisons and this work involves responding to the inadequate and often harmful health care policies and practices within state prisons. Since 1995, California prisons require a $5 medical copay from incarcerated people seeking medical, mental health or dental care. This practice undoubtedly undermines public health and individual well-being by forcing incarcerated people to choose between seeking needed health care, buying necessary hygiene items, or maintaining communication with their families.

“I made less than 8 cents an hour at my kitchen job but was still required to pay a fee to see the doctor,” says Taylor Lytle, a formerly incarcerated organizer with the California Coalition for Women Prisoners. “When I was sick, I had to choose between seeing a doctor and buying hygiene I needed like soap.”

Due to labor exploitation, incarcerated people currently earn only pennies per hour, with a majority earning less than $25 a month. Meanwhile, the nature of prison conditions, such as overcrowding and living in close quarters, puts incarcerated people at an increased risk of contracting communicable diseases. For example, in 2003, the federal Centers for Disease Control and Prevention identified copays as one of the factors contributing to an outbreak of MRSA among incarcerated people in Georgia, California and Texas.

“While a $5.00 copayment may seem small to those of us outside the prison system, a person in prison working for 8 cents per hour would need to work for over 60 hours just to afford one medical appointment,” says Assemblymember Mark Stone. “Limiting access to care in this way leads to unnecessary suffering, the development of more chronic conditions, and the spread of infectious diseases.”

Additionally, because of the overrepresentation of Black and brown people in California’s criminal justice system, a lack of access to needed health care exacerbates existing health disparities in these communities.

“The overwhelming majority of our state’s prison populations, nearly two-thirds, is Black or Latino. Compared to the segments of our population who are most susceptible to chronic health illnesses like diabetes, high blood pressure, and heart disease, preventing access to healthcare is even more critical than we can imagine,” said Taina Vargas-Edmond of Initiate Justice.

In September 2018, Governor Brown signed AB 2533, authored by Assemblymember Mark Stone (D-Monterey Bay), which raised the poverty threshold for incarcerated people from $1 to $25 per month, allowing people to receive a monthly issue of necessary personal hygiene items and the means to communicate with the courts (writing materials, notary service, etc.). The bill originally sought to exempt people under the poverty line from medical copayments, but this provision was removed before the State Senate passed the bill. This year, Assemblymember Stone introduced AB 45 which eliminates the burden of medical copayments for people seeking care in California prisons.

“For incarcerated people, a copay is a major barrier to accessing needed health care,” said Phyllida Burlingame, Reproductive Justice and Gender Equity Director of the ACLU of California. “By removing this barrier, AB 45 will be a step toward creating more just health care for people behind bars.”


About The Author

David Greenwald is the founder, editor, and executive director of the Davis Vanguard. He founded the Vanguard in 2006. David Greenwald moved to Davis in 1996 to attend Graduate School at UC Davis in Political Science. He lives in South Davis with his wife Cecilia Escamilla Greenwald and three children.

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7 thoughts on “Legislation Introduced to Eliminate Copays for People Incarcerated in California Prisons”

  1. Keith O

    I really don’t care about the $5 copay one way or another, but for this article to infer that all prisoners have is the 8 cents an hour income to rely on is false.  Most prisoners have access to banking acoounts in which they either already had money or their families and friends will donate to.

    1. Keith O

      Good idea, then it will also help keep them healthier so they won’t need as much healthcare.

      A win-win.

      If they don’t like it then maybe they will think twice about doing the crime.

  2. WesC

    Reality check:

    California prison inmates are not required to pay any co-pay for a medical visit related to any chronic disease such as diabetes, COPD, asthma, hypertension, arthritis, chronic renal disease, hepatitis, inflammatory bowel disease, cardiovascular disease, seizure disorders, any mental health problems, any other chronic medical conditions, follow-up appointments, or any medical appointment that was requested and scheduled on their behalf by a nurse, MD, NP, or mental health clinician.  They also do not pay a co-pay for any urgent/emergent appointment or for any prescribed medication, surgeries, or care given at an outside facility.

    They might for example pay a co-pay for an appointment if it was for a request for pain or allergy medication, medication to help them sleep,  to get a MD note to be excused from work or class, or a relatively minor or self limiting complaint. Even in these cases the decision to charge a co-pay or not is largely discretionary on the part of the clinician and is often not charged.

    Inmates are assigned to go to work or class whenever possible and are paid a small token wage whenever possible when it is a work assignment.  I once asked a warden how relevant to rehabilitation was a job in a shoe, clothing, eyeglass, etc. factory, because the only place he could use those skills upon parole was if he moved to China or some other similar country.  The warden told me that it was not the skill itself, but just getting them used to the fact that in the real world you have to get up every Mon-Fri and go to work from 8-5, and do this routinely month after month for many years no matter how you felt about the actual work.  He went on to say that a very large percent of the inmate population has never had a regular job in their life for any length of time and just getting up every day and showing up for work was a habit that they never developed, and is a work habit they will need upon parole wherever they end up.  He also said if they are at work or class every day they are not spending that time getting into gang trouble, fights, etc.  I have also had inmates tell me that they prefer the work assignments because it makes the time go by faster

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