Medicaid Overhaul Complicates States’ Plans to Bring Care Into Jails and Prisons

Washington is one of 19 states that have received federal approval to enroll people in Medicaid before they leave jail or prison — a radical change in Medicaid policy that health care and law enforcement leaders believe will save lives. But this experiment in bringing Medicaid behind bars is now colliding with H.R. 1, the sweeping federal law that is forcing states to make major changes to Medicaid.Guest(s):Autumn Boylan, Deputy director, California Department of Health Care ServicesLauren Brinkley-Rubinstein, Professor, Population Health Sciences, Duke University School of MedicineCody CoughenourPete Croughan, Deputy secretary, Louisiana Department of HealthBruce Greenstein, Secretary, Louisiana Department of Health Tyron Nixon, Medicaid Reentry Transformation Implementation Manager, Washington State Health Care AuthorityEmma Sandoe, Medicaid director, OregonPenelope Sapp, Chief of corrections, Kitsap County Sheriff’s OfficeMarc Stern, Former assistant secretary for health care at the Washington Department of CorrectionsTamara Vanover, Mental health specialist, Clallam County Sheriff’s OfficeLearn more: Read the full reporting and explore additional resources on our website.Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter.Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today.This episode was reported by Julie Wernau, edited by Dan Gorenstein and Ryan Levi, and mixed by Andrew Parrella and Cedric Wilson.The Tradeoffs theme song was composed by Ty Citerman. Additional music this episode from Blue Dot Sessions and Epidemic Sound.Special thanks to Gabrielle de la Gueronniere, Jody Rich and Kinda Serafi. Tradeoffs reporting for this story was supported, in part, by Arnold Ventures. Hosted on Acast. See acast.com/privacy for more information.

What this episode covers

Washington is one of 19 states that have received federal approval to enroll people in Medicaid before they leave jail or prison — a radical change in Medicaid policy that health care and law enforcement leaders believe will save lives. But this experiment in bringing Medicaid behind bars is now colliding with H.R. 1, the sweeping federal law that is forcing states to make major changes to Medicaid.Guest(s):Autumn Boylan, Deputy director, California Department of Health Care ServicesLauren Brinkley-Rubinstein, Professor, Population Health Sciences, Duke University School of MedicineCody CoughenourPete Croughan, Deputy secretary, Louisiana Department of HealthBruce Greenstein, Secretary, Louisiana Department of Health Tyron Nixon, Medicaid Reentry Transformation Implementation Manager, Washington State Health Care AuthorityEmma Sandoe, Medicaid director, OregonPenelope Sapp, Chief of corrections, Kitsap County Sheriff’s OfficeMarc Stern, Former assistant secretary for health care at the Washington Department of CorrectionsTamara Vanover, Mental health specialist, Clallam County Sheriff’s OfficeLearn more: Read the full reporting and explore additional resources on our website.Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter.Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today.This episode was reported by Julie Wernau, edited by Dan Gorenstein and Ryan Levi, and mixed by Andrew Parrella and Cedric Wilson.The Tradeoffs theme song was composed by Ty Citerman. Additional music this episode from Blue Dot Sessions and Epidemic Sound.Special thanks to Gabrielle de la Gueronniere, Jody Rich and Kinda Serafi. Tradeoffs reporting for this story was supported, in part, by Arnold Ventures. Hosted on Acast. See acast.com/privacy for more information.

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This episode was published on June 18, 2026.

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