Researchers have found that higher copays for health care obstruct access to receiving care behind bars, even as prison populations in Mississippi and nationwide face increasing rates of physical and mental health conditions.
One in 10 people with at least one chronic condition in state and federal prisons had not been seen by a clinician since they were incarcerated.
Wanda Bertram, communication strategist for the Prison Policy Initiative, said the copays are often less than $7 but they represent massive barriers to health care.
"If you want to be seen, you have to pay, typically anywhere from $2 to $5, or in the case of Mississippi prisons, $6,," Bertram outlined. "and if you can't pay that, either you can't see the doctor or that becomes a debt that you have to the prison."
The research found medical copays in prisons significantly impede health care access for more than 500,000 people with chronic conditions, from heart or kidney disease, to asthma and hepatitis C.
People in Mississippi prisons are not compensated for the jobs they may have while they are incarcerated, so Bertram pointed out it is up to their families to cover any medical costs. She added some states have dropped their copays for people behind bars. Her group thinks Mississippi should do the same.
"We have been advocating for years for states to abolish these copays," Bertram explained. "And some states are doing this, Nevada, I believe, abolished prison copays, either this year or last year. California has also abolished copays. To force people to pay to see a doctor, you know, causes people to not see doctors when they actually need help."
Bertram added the research revealed alarming gaps in mental health care access for incarcerated individuals. More than one-third of those with diagnosed chronic mental illnesses have not seen any mental health clinicians since entering prison.
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Some 7,000 people are expected to attend this week's Psychedelic Science conference in Denver and public health activists are spotlighting the potential for mind-altering medicines to help address the nation's overdose crisis and end decades of mass incarceration.
Amanda Hall, senior director of national campaigns for the advocacy group Dream.org, said Colorado is on the front lines of psychedelic drug therapies, which she said can improve mental health, treat post-traumatic stress disorder and help people overcome addiction to opioids and other harmful substances.
"Psychedelics can help with substance use disorder, help people really get on that road to recovery and get their life back," Hall explained. "We've seen studies that it can reduce alcohol consumption by over 80% for heavy drinkers."
In 2022, Colorado voters decriminalized the use of psychedelics, including psilocybin mushrooms, mescaline and DMT for people 21 and older. The state has started licensing healing centers, expected to open as early as this summer.
Psychedelics are still illegal under federal law, but U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. has supported decriminalization.
Hall believes psychedelic therapies forged in Colorado could work hand in hand with efforts to reverse the punishment-based approach in what she called the nation's "failed war on drugs." In addition to addressing addiction, Hall emphasized it is important to make sure people arrested for drug offenses have access to resources which could improve their chances to reenter and remain in communities.
"To recovery resources, to housing, to employment," Hall outlined. "Things that research show actually makes us safer as well, as opposed to just continuing to incarcerate people."
Drug offenses are a leading cause of arrests in Colorado and across the U.S., and people of all ethnicities and backgrounds use illicit drugs. Those who are prosecuted are disproportionately people of color. The U.S. has the world's highest incarceration rate, with more than 2 million behind bars at any given time. Nearly two million are Black, up from 360,000 during the 1970s.
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A new study highlights the high price of incarceration, and says the annual total cost to families of Americans behind bars is nearly $350 billion.
The study from the nonprofit FWD.us says one in two American adults has seen incarceration in their immediate family, with higher rates among Black Americans.
Families with a member in jail or prison spend about $4,000 a year, and the report says for Black families, the cost is more than double due to longer sentencing.
Zoë Towns - executive director of FWD.us - said expenses like phone calls, care packages, long-distance travel, and new costs at home all contribute to the exorbitant price.
"It also includes depressed wages over the lifetime of the person who's incarcerated, who's no longer able to contribute," said Towns. "But also to all the other members of the family who oftentimes are also now experiencing lower pay, just because of all of the shock of incarceration and the disruption that comes with that."
She added that the children of people behind bars usually see their own wages depressed throughout their lifetime, even after a parent is released.
Wisconsin's incarceration rate is among the highest in the nation. Black Wisconsinites are locked up at a rate nearly 12 times higher than whites, despite making up just 6% of the state's population.
The report shows incarceration rates are also higher for people in poverty, with subsequent expenses eating up more than a quarter of the family income.
Towns said the stigma around incarceration often means it's overlooked in discussions about household budgets.
"This report comes at a time when lawmakers and the American public are really thinking seriously about spending, about the price of everyday costs, they're thinking about affordability," said Towns. "And this is just one of those key drivers of affordability that is pretty significant and also under-discussed."
Towns noted that after 15 years of bipartisan criminal justice reforms to reduce incarceration, some political leaders are pushing to re-embrace it.
But she pointed out that states that have reduced incarceration have seen faster declines in their crime rates.
"And this is just another reminder of the harms of going backwards," said Towns. "It's not just that we don't need it, that it can't be defended on public safety grounds, it's also that it's coming at an extraordinarily high cost - not just to taxpayers, but directly out of the pockets of family members who are impacted by it, which is a great many people in America."
Towns said she hopes the research lifts up the stories of these families so policymakers can begin to address the issue more fully.
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By Alyssa Burr for the Michigan Independent.
Broadcast version by Chrystal Blair for Michigan News Connection reporting for the Michigan Independent-Public News Service Collaboration
Renee Chelian, founder and CEO of Northland Family Planning Center in Sterling Heights, has been an abortion provider for more than 50 years. During that time, she says, anti-abortion groups have harmed and harassed her, as well as her staff, patients and family, with constant threats of violence, including large blockades, arson attempts, and even death threats.
It wasn’t until the federal government enacted the 1994 Freedom of Access to Clinic Entrances Act, which sought to address the harm individuals obtaining and providing abortion care were facing, that she saw the violence lessen.
“Once the law went into effect, the violent blockade stopped immediately,” Chelian testified during a May 22 state Senate Civil Rights, Judiciary, and Public Safety Committee hearing. “We still had protesters, but they were not physically attacking our clinics, staff and patients.”
Three decades after the FACE Act took effect, Democrats in the Michigan Senate are working to create state-level safeguards that would protect Michigan abortion care providers and their patients in the event that the Republican-led Congress struck it from the books.
Republican-sponsored legislation to repeal the FACE Act is currently moving through the House of Representatives. Earlier this year, President Donald Trump pardoned 23 individuals who had been convicted of violating the FACE Act on charges of harassing pregnant patients, physically blocking clinic entrances, and breaking into medical facilities. Four of the pardons were for individuals charged with blockading Chelian’s Sterling Heights clinic in 2020.
Recalling the day of that blockade in committee, Chelian said that patients were stuck in their cars, including three women who had come in for abortions following the detection of fatal fetal anomalies in their pregnancies.
“One woman was leaking amniotic fluid and blood and was scheduled for the second day of a two-day procedure, and she needed immediate medical care. She huddled with her mother and her husband, trapped in the parking lot while extremists plastered signs of fake fetuses on her car windows and shouted, ‘God loves you, God loves your baby,’” Chelian said.
She added that day was traumatic for herself, her staff and her patients, with some even seeking mental health treatment. After Trump pardoned those convicted of attacking her clinic, she said it left them reliving their trauma and “feeling abandoned by the government.”
In March, state Sen. Mallory McMorrow, a Royal Oak Democrat, introduced Senate Bills 154 and 155, which mirror the FACE Act. The bills would do three things: prohibit a person from threatening, intimidating or interfering with someone obtaining or providing an abortion; prohibit an individual from intentionally damaging a health care facility that provides abortions; and create penalties for those who violate the bill’s provisions.
The legislation does allow certain exemptions for picketing or other demonstrations protected under the First Amendment, and it also specifies that a parent wouldn’t face any penalties so long as their interference is only directed toward their minor child.
“We cannot rely on federal protections that are actively being dismantled and pardoned away,” McMorrow said during the May Senate committee hearing.
The committee hearing featured testimony from Chelian, as well as other Michigan abortion providers who fear that extremism from anti-abortion groups could severely escalate if the FACE Act is repealed.
Dr. Neha Thawani is completing her obstetrics and gynecology residency at Henry Ford Hospital in Detroit. Since beginning her medical training eight years ago, she said, she’s passed through dozens of medical facilities offering a wide range of services, but it wasn’t until she spent time providing abortions in an outpatient clinic that she was “exposed to emergency lockdown protocols, a daily gauntlet of protesters, or saw patients escorted through side doors for their safety.”
Shelly Miller, executive director of the Scotsdale Women’s Center, a clinic in Detroit, said abortion providers have to go further than other parents in teaching their children safety measures: “It is not safe to open the mailbox alone. Never open a package without your parents, and you should certainly never discuss your parents’ line of work.”
“I need you to know there is nothing peaceful about these groups,” Miller told the Senate panel. “These are not kind-hearted people praying outside. These people scream horrible things at our patients, their chaperones and our staff. They shove their bodies close to us and our building entrances with force. … They post photos on social media, send hateful mail to our homes and aggressively run up on people as they try to get out of their cars. They have made recordings and then edited those recordings to use against us. They have been responsible for fires and bombings and ultimately killings of clinic staff and doctors around the country.”
If it enacted the law, Michigan would join 14 states and Washington, D.C., in providing legal protections to abortion clinic staff and patients from harassment or physical harm, according to McMorrow.
Genevieve Marron, legislative director for Right to Life Michigan, an anti-abortion group, submitted written testimony to the committee in opposition to the bills. In her letter, she said that the legislation is a “solution in search of a problem” because the FACE Act already covers the same area of law and that it would limit the reach of “sidewalk counselors,” anti-abortion activists who stand outside clinics and try to convince patients not to have abortions.
Since the U.S. Supreme Court overturned Roe v. Wade in 2022, ending the federal right to an abortion, Michigan lawmakers have taken steps to preserve reproductive health care in the state, including enshrining abortion access in the state constitution.
Even though the current bills are unlikely to make it through the Republican-controlled Michigan House of Representatives, McMorrow said the issue isn’t about ideology or politics; rather, it’s about continuing to provide basic safety and access to medical care.
“When activists can physically block patients from entering clinics, when they can break into medical facilities, when they can harass vulnerable patients without consequence, we have failed in our duty to protect both patients and health care providers,” McMorrow said.
Alyssa Burr wrote this article for the Michigan Independent.
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