California to Become First State to Stop Charging Copays in Jails and Prisons after Governor Signs New Law

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California to Become First State to Stop Charging Copays in Jails and Prisons After Governor Signs New Law

AB 45 will eliminate medical and dental copays for people incarcerated in California jails and prisons

(From Press Release – ACLU) –California Governor Gavin Newsom today signed historic legislation to permanently bar county jails and state prisons from charging incarcerated Californians copays and other fees for medical and dental services. AB 45, state legislation introduced by Assemblymember Mark Stone (D-Monterey Bay), goes into effect January 1, 2020, making California the first state in the country to abolish the practice of charging copays in county jails. Nine other states have either eliminated or not instituted prison copays.

“Copays in custody are an obstacle to healthcare and create public health nightmares. We have been organizing across prison walls to improve access to healthcare and end copays for years. I am proud to be part of this historic effort and know our incarcerated members will be greatly relieved to have less barriers to healthcare,” said Romarilyn Ralston, Policy Director with the California Coalition for Women Prisoners.

California, like most states, has charged incarcerated people a copay—five dollars in prison and three dollars in most jails—to access medical, mental, or dental care, in addition to fees for medical equipment such as glasses and dentures. Due to labor exploitation, people in prison earn pennies per hour, and a five-dollar copay for them is the equivalent of a more than six hundred-dollar copay for someone making minimum wage. Meanwhile, people in jail earn nothing for their labor. When factoring in costs for over-the-counter medicine, basic toiletries, and materials like phone cards, stamps, and paper for maintaining contact with loved ones, copays pose a serious barrier to healthcare access and deter many incarcerated Californians from seeking care until it is an emergency.

“What we saw with these copays was a two-tiered system – those incarcerated with family able to send money could see a doctor, while those with less means were effectively barred from accessing healthcare,” said Derick Morgan, Policy Associate with the Ella Baker Center for Human Rights. “We thank Governor Newsom for signing AB 45 into law. For the thousands of families waiting for a loved one to come home after serving their sentence, this is a relief.”

Lack of access to timely and adequate care puts incarcerated people at increased risk for worsening illnesses. Living in close quarters and crowded environments also puts incarcerated people at heightened risk of contagion. This jeopardizes incarcerated people as well as staff, volunteers, and family and friends who visit the facilities. In 2003, for example, the Centers for Disease Control and Prevention identified copays as one of the factors contributing to a MRSA outbreak among incarcerated people in California.

Citing public health concerns, the California Department of Corrections and Rehabilitation (CDCR) voluntarily decided to eliminate copays in state prisons earlier this year. AB 45 will make the CDCR’s decision state law.

“The governor’s decision to permanently remove copays from California jails and prisons brings us one step closer to fair and just access to healthcare for everyone, including those who are incarcerated,” said Eric Henderson, Policy Director with Initiate Justice. “While a copay seems small, it is a significant barrier to accessing care. I applaud the CDCR for removing the copay from prisons and the governor for making this permanent and extending it to jails.”

Lack of access to healthcare during incarceration also has racially and economically disparate impacts because Black Californians and low-income people are overrepresented in jails and prisons. In eliminating copays, AB 45 removes a barrier to care that has exacerbated existing health disparities.

AB 45 was sponsored by the Union of American Physicians and Dentists, Initiate Justice, Ella Baker Center for Human Rights, California Coalition for Women Prisoners, and the ACLU of California.


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3 thoughts on “California to Become First State to Stop Charging Copays in Jails and Prisons after Governor Signs New Law”

  1. Bill Marshall

    Good to see the change… ’bout time… right thing to do [unless someone gets arrested for the purpose of dealing with a ‘pre-existing condition’]   (Am thinking that is a real remote possibility, except, perhaps, with the homeless, some of whom have significant dental/medical issues)

    … despite the obvious hyperbole of the author.

    Gets to the question of medical/dental/mental health coverage/services, at least for basic services, particularly preventative, for everyone.  Including the incarcerated, and the poor and/or homeless.  Preventative/early intervention care is cheap ‘insurance’ in the long run, not just for individuals, but also for society in general.

  2. Eric Gelber

    On a different but related note, under state law, involuntarily committed patients of state psychiatric hospitals, unlike convicted prisoners, are liable for their cost of care and treatment—amounting to hundreds of thousands of dollars per year. Any money received by the patient while in a state hospital must be put into a client trust account. Any amount exceeding $500, except for certain exempt federal benefits (e.g., Social Security or Veterans benefits), can be taken by the state.

    The exempt $500 is presumably to enable the patient to transition back into the community. Obviously, this sum, established decades ago, is insufficient (e.g., to pay move-in costs for an apartment), meaning patients often leave the state hospital destitute and at a great disadvantage to find housing and successfully reestablish themselves in the community. Just one more example of how the state treats its mentally ill and contributes to the problem of homelessness and mental illness.

    1. Bill Marshall

      Good points, Eric… not seeing much of a difference (if any)… usually those incarcerated are “involuntary committed”, as well… if there is family, in either case, and they are of “substantial means”, I’m open to co-pays from them… most in incarceration or involuntary commitment, don’t have strong family ties, to families of “substantial means”… good points… add the ‘homeless’ (often involuntary, or have Medical/MH issues), we’d be nearly perfectly aligned.

      You’ll note, in an earlier post, that it should be medical/dental/MH care…

      But, going to extremes, if a $3 mm/year sports icon, has a child, spouse, close relative in those situations, they should “step up to the plate”, and not pass it off to the public… just my opinion… heck they only pay SS/Medicare rates at de minimus  rates…

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