I 
115TH CONGRESS 
2D SESSION 
H. R. 6764 
To amend title XIX of the Social Security Act to provide a consistent 
standard of health care to the incarcerated. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 10, 2018 
Ms. KUSTER of New Hampshire (for herself, Mr. CARSON of Indiana, Mr. 
RYAN of Ohio, Ms. BASS, and Mr. CICILLINE) introduced the following 
bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to provide 
a consistent standard of health care to the incarcerated. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Humane Correctional 
Health Care Act’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) According to the Bureau of Justice Statis-
tics, since 1965, the U.S. inmate population has 
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grown by 650 percent: from approximately 200,000 
to 1.5 million inmates. 
(2) Prison and jail health care is currently the 
responsibility of the States, counties, and cities. A 
study by the Pew Charitable Trust determined that 
health care spending in the prison system has grown 
substantially over the past several decades, driven 
largely by litigation, and amounted to $8.1 billion in 
2015. Prison health care spending varies dramati-
cally from State to State, but inconsistent ap-
proaches to quality measurement and monitoring 
make interstate comparison of the quality of care 
not possible. 
(3) Research published by the National Insti-
tutes of Health found that jail and prison inmates 
have a higher occurrence of most chronic medical 
conditions than the general population. 
(4) According to the University of Pennsylvania 
Public Policy Center, the quality of prison health 
care is generally known to be poor, has no standard 
of care (level at which the average, prudent provider 
in a given community would practice), and has been 
the subject of numerous lawsuits. 
(5) The Bureau of Justice Statistics reports 
that 37 percent of prisoners have a mental health 
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disorder, yet only approximately a third of those re-
ceive treatment. 
(6) The National Center for Addiction and Sub-
stance Abuse at Columbia University estimates 65 
percent of individuals in prisons or jails meet the 
clinical criteria for substance use disorder (SUD), 
yet the use of Medical Assisted Treatment (MAT) 
for those with SUD is limited. There is currently no 
mechanism to pay for sustained MAT in the crimi-
nal justice system. 
(7) President Trump has endorsed the goal of 
making addiction treatment available to those in 
prison. 
(8) A study published in the International 
Journal of Law and Psychiatry states that 68 per-
cent of untreated SUD and dual diagnosis (SUD 
and mental disorder) offenders returned to prison 
with an average annual cost of incarceration of 
$31,977. 
(9) With a repeal of the Medicaid inmate exclu-
sion, nearly all inmates would be eligible for the 
Medicaid program in States that expanded Medicaid 
through the Patient Protection and Affordable Care 
Act; thus, Medicaid could provide a sustained mech-
anism to pay for MAT, mental health treatment, 
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and general health care for a large portion of the in-
carcerated population. 
SEC. 3. REPEAL OF MEDICAID INMATE EXCLUSION. 
Section 1905(a) of the Social Security Act (42 U.S.C. 
1396d(a)) is amended, in the matter following paragraph 
(29), by striking ‘‘such term does not include—’’ and all 
that follows through ‘‘who is a patient in an institution 
for mental diseases.’’ and inserting ‘‘such term does not 
include any such payments with respect to care or services 
for any individual who has not attained 65 years of age 
and who is a patient in an institution for mental dis-
eases.’’. 
Æ 
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