Jailer says repeal of Obamacare and Medicaid expansion could wreak havoc on jail budget

Anderson County, Kentucky, Jail

A rural Kentucky jailer says repealing the Patient Protection and Affordable Care Act could cause big problems for the budget of her jail, reports Ben Carlson of The Anderson News in Lawrenceburg, in a story with potential national implications.

The operating budget for the Anderson County Jail is just under $1 million, but Jailer Joani Clark has been forced to request large funding increases in the past few years, mostly because of the opioid epidemic that has brought more inmates with attendant medical expenses.

"Since Obamacare kicked in, the jail's inmates are charged the Medicaid rate for payment of hospital, doctor bills, etc., when they're in custody," Clark said at a recent meeting of the Anderson County Fiscal Court. "If this all goes away, the county will be paying all hospital and doctor bills and any other type of medical at full regular prices."

According to Clark, inmate medical services cost local taxpayers almost $32,000 during the 2016-2017 fiscal year. But Medicaid coverage for some of those services saved the county almost $170,000. "If an inmate has to be admitted to the hospital for more than 24 hours, Medicaid will pay all the bills in full," Clark said, also noting that many inmates have taken advantage of free injections offered to help them keep their heroin addictions under control. The normal cost of the Vivitrol injection, given once every 30 days to control a heroin addition, is $700-$1,000.