Multnomah County's Wapato Jail

A dentist's station at Multnomah County's never-opened Wapato jail awaits patients. Under the Affordable Care Act, the county might be able to pass some of the cost of providing medical care to inmates onto the federal government.

(Thomas Boyd/The Oregonian)

Backers have promoted the Affordable Care Act and Medicaid expansion as a way to reduce health care costs for many Americans.

Multnomah County officials expect national health care reform to cut the county's medical bills, too.

By enrolling jail inmates in nationally subsidized healthcare -- best known as "Obamacare" to both the President and his critics -- the county could bill the federal government for the cost of providing some of them medical care.

County health department officials briefed Multnomah County commissioners on the issue this week.

In addition to saving the county money, enrolling inmates in Obamacare would also mean a significant percentage will now have insurance when their jail stay is done.

The county's corrections health care team has begun a push to enroll jail inmates in Medicaid or other forms of coverage. Seven "eligibility specialists" began working this week to help inmates complete their insurance applications, and they signed 22 inmates up for continuing care during their first day on the job.

County health officials say they hope to create a "warm handoff" from in-custody care to civilian care. Often, uninsured inmates who can't afford medical bills forego treatment once they are released from jail.

"The jail is the primary place where many inmates receive care, and we are trying very hard to change that, said Nancy Griffith, the county's director of corrections health.

National jail standards require governing bodies to provide healthcare for inmates. Historically, the cost has fallen upon the local government running the jail.

Multnomah County pays to provide mental health, dental, and medical care to 35,000 inmates yearly, at a cost of $15.7 million to the county, county spokeswoman Julie Sullivan said.

Under the Affordable Care Act, the county will still be responsible for funding in-jail care of inmates who are on Medicaid, but the county could bill Medicaid for inmates' hospital trips of longer than 24 hours. That alone could bring a savings of $1 million annually.

County officials believe new provisions in the Affordable Care Act could also allow inmates who are privately insured to bill their provider for services received while they are in jail, but have not yet had a trial.

County officials estimate about 70 to 80 percent of the jail population is eligible for Medicaid, while up to 10 percent are privately insured.

"If there's a venue to be reimbursed and we're eligible, we're going to be pursuing that," said Vanetta Abdellatif, the county health department's director of integrated clinical services.

My colleague, Les Zaits, wrote in November about a similar state program to enroll prisoners in Medicaid. Read that story, and keep following our coverage for more on Multnomah County's inmate health reform as details about the program solidify.

--Kelly House