Over the last 40 years, the nation’s courts have consistently ruled that health care is a constitutional right for the country’s 2 million prisoners. To be sure, the quality of that care — delivered largely by contracted, for-profit companies — has been generally abysmal, but that hasn’t eroded the legal and constitutional imperative to provide it.
Pennsylvania, however, hasn’t treated prisoner health care as a constitutional or human right. By imposing $5 co-pays on prisoner health care, it has erected unreasonable barriers to essential care for inmates. They earn an average of 42 cents an hour, and some much less, for institutional jobs — a rate requiring 12 hours of labor to meet a medical co-pay. But there aren’t enough prison jobs to provide work for every inmate.
Discouraging sick prisoners from getting necessary health care also poses risks and costs to communities, especially through unmanaged chronic diseases; 95% of those who enter state prisons will eventually get out.
To meet its obligations to the public, and to the 37,000 people in Pennsylvania state prisons, the Department of Corrections should immediately suspend medical co-pays; the General Assembly should eliminate them permanently by passing House Bill 1753. The bill, sponsored by Rep. Amen Brown, D — Philadelphia, is now in the Judiciary Committee.
At the urging of Brown, the Pennsylvania Department of Corrections, under former Secretary John Wetzel, suspended co-pays during the height of the COVID epidemic. Eliminating the co-pays permanently would not impose a financial hardship on the department. The co-pays generated roughly $400,000 a year, far less than 1% of the prison system’s $2 billion annual budget.
Physicians for Criminal Justice Reform has also called for the Department of Corrections to end medical co-pays in Pennsylvania state prisons. In a letter last month to Acting Secretary George Little, the physicians’ group called them a “prohibitory barrier” to medical care. It noted prisoners have high rates of chronic medical and psychiatric conditions that can, untreated, quickly advance to severe and life-threatening illnesses, and that a 2019 study found that 60% of prisoners in Illinois avoided seeking care due to co-pays.
Supporters of prison co-pays have argued they promote responsibility in using the health care system. That might be true for people with real choices. But it’s a naïve and specious argument when applied to people who don’t have money, or must choose between health care and food, or health care and phone calls to family members and loved ones. “Because of their financial circumstances, inmates are already losing contact with their loved ones,” Brown said. “Families are being torn apart.”
— Pittsburgh Post-Gazette via AP
