Although prisons are required to provide inmates with healthcare services, that doesn't mean such services are free. In most states, people who are incarcerated may be responsible for copayments ranging from the single digits to $100 for medical care, NPR reported.
At least 35 states permit inmates to pay copayments and other fees for medical services at state prisons or county jails, analysis by the Brennan Center for Criminal Justice at New York University School of Law found. Some states and local governments require such payments for emergency treatment and hospitalizations, as well as for routine care, according to Lauren Brooke Eisen, senior counsel at the Brennan Center's justice program and author of the study.
"It's understandable why jurisdictions need to increase their revenue," Ms. Eisen said, according to NPR. "From a public policy standpoint, however, the fees can serve as a deterrent to getting care."
The Federal Bureau of Prisons also authorizes prisons to hold inmates accountable for copayments for medical services.
The practice is part of a growing trend of charging prison inmates for services, such as room and board fees while being incarcerated, phone calls and Internet use in addition to medical care. The idea behind the fees is to reduce the demand for services, but even small fees may deter prisoners from making requests for medical care that is necessary to keep chronic conditions under control or treat communicable diseases that could easily spread, according to the report.
An estimated 80 percent of prisoners are poor. They pay medical copayments from commissary accounts, which are typically funded by family members and earnings from prison jobs.
"Prisoners don't have money; they're getting $20 a month from their family," said Robert Greifinger, MD, former CMO of the New York Department of Corrections. "If they deplete that for medical care, they don't have money for underwear, soap or food."
Because many inmates are uninsured when they enter the prison system, they often don't get the care they need. Among those with chronic medical conditions, many didn't receive a medical exam during their incarceration, including 68 percent of local jail inmates, 20 percent of state prison inmates and 14 percent of federal prison inmates, according to a 2009 study published in the American Journal of Public Health, NPR reported.