by Daniel A. Rosen |
In most states, inmates pay an average of $2 to $8 copays for medical appointments, lab tests, and medication. But as prisons across the country have become COVID hotspots, some corrections departments are waiving the fees to encourage inmates to seek treatment for virus symptoms.
Most states say they charge the fees to discourage inmates from abusing the medical system and overtaxing their staffs; about three quarters of states in the U.S. charge some co-payment for medical services.
Connecticut’s DOC waived its $3 medical copays in March, as the virus spread throughout the state.
“We didn’t want the lack of funds to be a reason offenders were denied medical treatment, especially during the pandemic,” said Andrius Banevicius, of the state’s corrections system. “We wanted as many offenders as possible to have access to medical care.”
Since inmates in most states earn from $0.14 to $0.63 cents per hour, a few dollars in copay charges can amount to the equivalent of hundreds of dollars for free citizens, and a single visit can cost several days wages or more.
Other states have taken a different approach. In Arkansas, the state waived copays for a month and then reinstated them, saying they were buried with non-pandemic-related medical requests. Inmates who show COVID symptoms are now exempt from the fees, and indigent patients can get treatment regardless of their ability to pay.
Arkansas inmates have sued over prison conditions including medical copays, arguing that financial barriers to medical care risk inmate lives. After the state’s copay policy was put into effect, one inmate says it noticably affected medical care.
Kaleem Nazeem spent over twenty years behind bars in Arkansas. He says after the policy change, inmates were requires to endure multiple medical visits before being designated as ill enough to see a doctor, and they were charged co-pays each time.
“When guys have ailments that aren’t life-threatening from a self-diagnostic perspective, they don’t want to go to the infirmary, because they don’t want a lien on their account or to waste $3 to be told they need ibuprofen,” Nazeem said.
Connecticut and 10 other states have waived medical co-pays due to the pandemic, but many others have suspended the fees only for those with COVID symptoms. Some corrections departments made the changes on their own, while others were forced by the courts to remove the medical fees.
Nevada charges inmates $8 per sick call, to defray the costs of inmate medical care, according to a spokesman. Scott Kelley said that prison officials won’t charge inmates “when there is clear evidence the medical service is directly COVID-19 related.”
Waiving co-pays only for symptomatic patients is also problematic, given CDC estimates that 40 percent or more of those infected with the virus are asymptomatic. Some prisons, like Marion Correctional Institution in Ohio, reported that as many as 95 percent of inmates infected showed no symptoms.
A recent study by medical experts found that medical co-pays can become a barrier to proper treatment and can aggravate disease outbreaks. The study in the American Journal of Preventive Medicine found that high fees can “prevent the timely identification, isolation, treatment, and referral” of COVID-19 cases. The study recommended eliminating medical fees during the pandemic.
The National Institute of Health recommendations for corrections departments also advocates that states “Eliminate medical copays for prisoners,” and to “Urge symptom reporting from prisoners and staff.” The NIH report reminds corrections officials that the well-being of inmates “is inexorably linked to the health of the country as a whole.”