Reentry Act Grants Medicaid Coverage 30 Days Before Prison Release, Mandates Deep Dive into Correctional Healthcare

The newly introduced Reentry Act of 2025 is tackling a major gap in healthcare coverage for people leaving prison or jail. The core change is simple but impactful: it allows incarcerated individuals to receive medical assistance through Medicaid during the 30 days immediately preceding their release (SEC. 2).

Bridging the 30-Day Gap

Currently, federal law generally blocks Medicaid coverage for inmates, which means that when someone walks out of a correctional facility, they often go from having structured, if sometimes inadequate, medical care to having zero coverage overnight. This is particularly dangerous for people managing chronic diseases like diabetes or hypertension, or those needing continuous mental health or addiction treatment. This bill creates a 30-day runway for Medicaid to kick in, which is huge for continuity of care. It means that when someone gets out, they can already have their appointments scheduled, prescriptions filled, and treatment plans in place, significantly improving their odds of staying healthy and stable during the critical transition period. For the rest of us, this is a benefit because better health outcomes for reentering individuals often translate to lower emergency room visits and reduced recidivism rates down the line.

The Mandate for Transparency

Beyond the immediate coverage expansion, the bill includes a major accountability measure: it mandates that the Medicaid and CHIP Payment and Access Commission (MACPAC) conduct a comprehensive review of healthcare within correctional facilities and submit a report to Congress within 18 months of the law’s enactment (SEC. 2, Medicaid Report Requirement). This isn’t just a quick check-in; MACPAC must analyze everything from the safety and health standards inside prisons to the quality of care they actually provide, including mental health and substance abuse services. They are also tasked with comparing the accreditation standards used in correctional facilities against those used in community hospitals.

This report is designed to pull back the curtain on correctional healthcare. For state correctional systems, this means increased scrutiny and potential pressure to align their care standards with those of the broader medical community. MACPAC also has to analyze how many people will qualify for the new 30-day coverage and how smoothly the coordination between prisons and State Medicaid agencies is actually working, which addresses the practical challenge of enrollment. If the process is clunky, people won't benefit, so this analysis is key.

The Real-World Impact and Cost

While the benefit to individuals is clear—better health and a smoother transition—there are two groups that will feel the immediate impact. First, the Medicaid program will incur new costs for covering this population during the 30-day pre-release window (SEC. 2). Second, state correctional systems will be the subject of this mandated federal review, which could lead to future regulatory changes and increased costs if their current healthcare standards are found lacking. MACPAC is also authorized to provide recommendations to Congress and the Department of Health and Human Services (HHS) for any further actions needed to ensure comprehensive post-release coverage, especially for addiction treatment. While this is a positive goal, the broad scope of these future recommendations could lead to further policy changes down the road.