Instead of the city paying for health care, the city will pay for health insurance for those inmates willing to sign up through the Affordable Care Act.
Bowers said that there is currently a detainee awaiting trial on felony charges who has been diagnosed with a serious medical condition requiring ongoing expensive medical care. He has been determined as indigent for purposes of qualifying for court appointed counsel. He has indicated he would consent to applying for Affordable Care Act health insurance coverage if the city pays for it This
If an inmate has private insurance, their insurance is billed for their medical expenses. If an inmate is on Medicaid or Medicare those services are discontinued by law while incarcerated, leaving it to the city to pay for health care.
In 2011 the City of Anacortes negotiated with Skagit Valley Hospital and Island Hospital for a discount on medical services provided at their facilities; however, this does not apply to prescriptions. Prior to 2011 the City paid the regular rate of medical costs to all service providers.
The costs associated with this required medical care is difficult to budget for because it varies based on the medical conditions of the inmates. The City of Anacortes costs are represented in the chart below.
Total medical costs
2005 - $4,595
2006 - $9,079
2007 - $19,880
2008 - $18,612
2009 - $21,775
2010 - $19,088
2011 - $6,341
2012 - $29,228
2013 - $20,961* (Outstanding invoices will increase this expenditure)
Typically, if an inmate is in need of extensive medical treatment, they are released by court order to allow them to receive necessary medical care and their jail time is postponed until they are healthier. There are cases of chronic illness that must be treated in custody and very infrequently there are cases where an inmate is too great a risk to the community to be released.
The Anacortes City Council has authorized staff to submit enrollment applications on behalf of (and with the consent of) the persons in custody in situations where ongoing medical attention is required by an Inmate and where a cost/benefit analysis demonstrates it would be more cost-effective to obtain a health insurance policy than for the City to pay the associated medical costs directly. This is only possible if:
- The inmate gives consent
- The inmate is indigent (without financial means to purchase their insurance)
- The inmate is ill, injured, or has a chronic medical condition that requires immediate treatment.
Bowers said, “The City does not anticipate using this alternative often but it may be more cost effective in certain situations. The City of Anacortes is the first city in our area to adopt this type of resolution but we are certainly not alone in considering this approach.”
Bowers is in the process of determining the cost benefit of insuring the current inmate with a serious medical condition.