Impacts of the Affordable Care Act on the Justice-Involved, Crime Victims, and the Criminal Justice System in San Diego County

Over 60,000 individuals pass through San Diego County jails annually, and 90 percent have no health insurance when they are released. With the expansion of Medicaid under the Affordable Care Act, the majority of this population is eligible for insurance that includes coverage for mental health and substance use disorder treatment. Recognizing the opportunity, the County of San Diego has brought together stakeholders from various disciplines to ensure an effective system to enroll people who come into contact with the criminal justice system into healthcare coverage.

The ACA can similarly benefit victims of crime. As a majority of crime victims are low-income, Medicaid expansion can provide coverage for many crime victims. Further, the ACA requires that all insurance plans cover free domestic violence screening and counseling for women. An opportunity for law enforcement exists to connect crime victims to needed services to improve health and safety.

With expanded coverage for mental health and substance use disorder treatment, the ACA shifts the treatment of these conditions from a criminal justice approach to one of public health. Opportunities exist at various stages in the criminal process to assure people are connected to needed health interventions, including appropriate alternatives to custody.

This presentation will detail efforts in San Diego County to enroll the justice-involved into health coverage, both pre- and post-release. It will explain how the ACA benefits crime victims and potential for collaboration on this issue. The presenter will discuss opportunities the ACA presents for innovation in the criminal justice system.