Medicaid Expansion to Achieve Health Equity - Rebekah Gee

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Photo by Hush Naidoo on Unsplash

Dr. Rebekah Gee, former Secretary of the Louisiana Department of Health, spoke on The Dose podcast by Shanoor Seervai, in conversation with Vikki Wachino, head of Community Oriented Correctional Health Services nonprofit organization. These influential women discussed the healthcare of the incarcerated upon release of the criminal system. As a champion in healthcare equity, Dr. Gee oversaw Medicaid expansion during her time in the department of health.

Read what Dr. Gee said below.

“When individuals are incarcerated, they usually get treatment when they’re symptomatic. So the kinds of things that happen for those of us who are on the outside, like screenings for cancer, regular checkups, making sure diabetes is under really good control, typically don’t happen because the resources aren’t there to do really good preventive care.”

“Not only do the inmates have a weak healthcare system while incarcerated, but it is even more difficult to obtain healthcare upon release.

“The Medicaid expansion in Louisiana allowed us to create a prerelease program that connected individuals who were incarcerated to Medicaid, a health plan, primary care and a case manager prior to release. And then, within seven to 10 days’ post-release, Medicaid benefits remain active. And so because of this effort, which has benefited over 7,000 individuals leaving our criminal justice system, we’ve been able to find a lot of individuals who needed special help.

“One of them was a client who had served more than 35 years at Angola, who had been told that his hepatitis C was cured. But that wasn’t true. And when he was tested after his release, it was found that he had hepatitis C. Because of our program, that was the first in the nation effort to have a subscription model for hepatitis C medications for everyone. Not only for those who are incarcerated, but those in Medicaid. He was able to be diagnosed with hepatitis C, receive treatment and be cured. And what he said is that he feels amazing for the first time in 20 years.

“So this new program allowed him to come home, be healthier during that transition, and be prepared to receive medical care all in a seamless manner. This is such a difference from what would have happened before, where all that was offered to most individuals leaving was a bus pass and a ‘good luck.’

“The only health care you would have access to would be, if you could get a job, which is very challenging right out of jail. Or if you had such a severe disability that would qualify you for Medicaid, but that was very difficult prior to expansion. Also if you went to an emergency room.”

Rebekah then went on to define health equity and what that means for individuals.

“Well, I define health equity as every individual being able to achieve his or her optimum health. Black individuals are disproportionately more incarcerated, 67 percent of people in jail are Black in Louisiana, and only about 30 percent of our population is Black. So addressing the needs of prisoners is very important to achieving health equity. Also, as Vikki mentioned, a lot of individuals are in jail because they had conditions that were untreated, like mental health and substance use disorder.

“Having access to treatment is important and it allows individuals a better chance of staying in their community, of being successful in reentry, and of having lives that are successful going forward. Part of achieving health equity is not forgetting about anyone. Every human being matters and so do those who are in jail or prison also matter. With our work in Louisiana on hepatitis C, we ensure that we treat it, and that we’re able to treat everyone in jail with hepatitis C. It is also important as a health equity initiative that we don’t neglect the needs of Americans just because they’re incarcerated.”

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