The burden of prison medical costs, another barrier for the incarcerated finding healthcare

For people earning 14-63 cents an hour in prison (many earn nothing at all for their work), a typical $2-5 copay is the equivalent of charging a free-world worker $200 or $500 for a medical visit.

 We go to the Prison Policy Initiative for a study on prison copays. Below are excerpts.

Summary By: Natalie Mattson
Summary By: Natalie Mattson

The Study's Critical Points

In 2017, only eight states did not charge medical copays for incarcerated people: Missouri, Montana, Nebraska, New Mexico, New York, Oregon, Vermont, and Wyoming.


  • This study reviewed each state’s policy on the topic and any temporary changes they’ve made during COVID-19. 

  • Since 2017, California and Illinois have eliminated medical copays. 

  • For the last two years, Virginia has suspended medical copays as part of a pilot program. 

  • Texas reduced its exorbitant $100 yearly health care fee to a less atrocious, but still out-of-reach, $13.55 per-visit fee.

  • Idaho also reduced its medical copays in prison from $5 to $3 in 2018.

  • Twenty-eight states modified their policies during the first few months of the pandemic, and, ultimately, all but one state — Nevada — temporarily changed their policies.

  • Most states that have modified their copay policies during the pandemic only suspended copays for respiratory, flu-related, or COVID-19 symptoms. But these limitations ignore the facts that not all COVID-19 symptoms fall within these vague categories, and many people don’t display symptoms at all.

  • Five states — Alabama, Arkansas, Idaho, Minnesota, and Texas — rolled back their COVID-19 copay modifications at some point during the pandemic. 

  • Alabama went from suspending all copays to reinstating them for all cases in December 2020. 

  • Minnesota and Texas had modified copays to accommodate people with COVID-19 symptoms, but reinstated all copays in December 2020 and September 2021, respectively. We confirmed that 22 states continue to operate with their COVID-19 copay policy changes in place.


Read the whole study here.

VISUAL Breakdown

Above: A graphic depicting state prison co-pays.


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