Medicaid Expansion and the Access to Community Treatment Court
The fate of the Affordable Care Act and the Medicaid expansion, is uncertain. Illinois was one of the first states to embrace the Medicaid expansion in 2013, and it was instrumental in supporting the Access to Community Treatment court, a project of Chicago Appleseed.
The Access to Community Treatment Court is a problem-solving court in the Criminal Division in the Circuit Court of Cook County specifically designed to treat repeat offenders who are dependent on drugs and who would otherwise be sentenced to a prison term. In two years of existence, the ACT Court has served nearly 200 individuals and there have been 89 graduates of the program. It operates under a justice reinvestment grant from Adult Redeploy Illinois, demonstrating a meaningful cost-savings to the Illinois Department of Corrections.
The ACT Court has operated for three years with a budget of under a million dollars annually, however it was diverted 151 individuals (between graduates and current participants) from getting an average of 18 months of incarceration each in the Illinois Department of Corrections–which has an annual cost to incarcerate an inmate of $38,268—resulting in approximately $8,036,280.00 in savings to the state.
One of the ACT Court’s first participants, said upon graduation, “All my life, it seems, I’ve been going to jail for the use of drugs. I thought drugs were my best friend. I’m 54 years old, but I’ve been going to jail since I was 12. The drugs kept me occupied and comforted.” She then went on to describe how getting sober had enabled her to be a positive presence in her neighborhood.
None of the work of the ACT court—none of the lives changed—would be possible without the expansion of Medicaid under the Affordable Care Act. Before the ACA, many of the individuals in the criminal justice system would be ineligible for Medicaid while also being unable to afford private health insurance. However, due to the expansion the ACT Court has been able to help treat individuals and turn around decades of addiction and criminal behavior. Moreover, with Medicaid expansion covering drug treatment, funding from other sources could finally be used for those things that are critical for recidivism reduction but often not funded via insurance, including cognitive behavioral therapy and access to recovery homes.