Justice Reform Could Cut Healthcare Spending, Combat Potential Crisis

by Wyoming Liberty Group Staff

Criminal justice reform legislation will be on the agenda in the upcoming 2017 Wyoming Legislative General Session. Much has been said about criminal justice reform and its potential to save taxpayer dollars. The conversation typically revolves around lowering administrative costs, downsizing staff, and avoiding future prison construction. But, reforms could also reduce the growing cost of prison healthcare.

In recent years, the price tag for inmate healthcare has exploded. Between 2007 and 2015, the Wyoming Department of Correction's budget for inmate healthcare has risen from $15 million per year to $40 million per year – an increase of 166 percent. The rise in costs could be attributed to a number of variables but some are more clear than others.

For instance, the average age of Wyoming's inmate population is increasing at an alarming rate. According to the grassroots advocacy group, Wyoming Corrections Reform, Wyoming's inmate population, 50 or older has risen from 5 percent of the total male prison population to 15 percent. By 2019, they could account for nearly 25 percent of those in prison.

Older inmates are among the most expensive to treat. Many require around-the-clock attention as well as expensive, prescription drugs and treatments. The U.S. Department of Justice estimates an elderly inmate costs on average, $58,956 per year when you factor in their medical care; nearly double the annual cost of younger prisoners.

Common sense criminal justice reforms could offer some relief. In November, the Wyoming Legislature's Interim Joint Judiciary Committee unanimously sponsored a bill that would offer early parole and release for non-violent offenders showing behavioral rehabilitation. These changes could cut correctional healthcare costs substantially – especially when applied to older inmates.

Another section of the bill contains a sentencing reform proposal which would allow first time, non-violent offenders to be placed on intense supervision rather than more time spent behind bars. By diverting non-violent criminals away from state custody, the state might avoid the expense of the offenders' healthcare. While it is difficult to estimate how this portion of the bill would cut costs short-term, decreasing the overall prison population is certain to do so over the long-term.

These changes could also rescue Wyoming from a looming prison healthcare crisis that's sweeping the nation. Since 2013, the pharmaceutical company, Gilead Sciences, has developed medications which cure 95 percent of patients with Hepatitis C. There's just one problem, treatments can cost over $84,000 to administer this medication over a 12-week course per patient.

These medications could present a significant financial burden for Wyoming's corrections system. According to a study in Health Affairs, roughly 13 percent of Wyoming inmates are infected with Hepatitis C – 30 times the rate observed amongst the general population. If administering the drug to those infected became a requirement, the treatments could cost more than $25 million.

So why don't prisons simply refuse to offer the pricey medication? It's because over the last two years, inmate advocates have sued multiple states for refusing to provide Giliead's lifesaving drugs to offenders. They argue that refusing to provide cures to infected inmates is cruel and unusual punishment, which is forbidden by the Eighth Amendment of the Constitution. Gavin Rose, an attorney for the American Civil Liberties Union, is currently suing the state of Indiana on grounds that "[a] medically necessary treatment is a medically necessary treatment, no matter what the cost" (emphasis added).

In theory, the courts agree that "deliberate indifference to serious medical needs" is indeed a violation of prisoners' Eighth Amendment protections. But the line is blurry as to where the drug becomes a necessity. Prisoners who show significant warning signs such as severe liver damage or vascular swelling are considered to have priority. But if the courts decide that all infected inmates have a right to these treatments, the costs would overwhelm state budgets.

Chris Gautz, a spokesman for the Michigan Department of Corrections, recently told the polling website, FiveThirtyEight, that his state has already spent $26 million providing Sovaldi and Harvoni to 400 inmates, even after negotiating a 65 percent discount from Gilead. California's Department of Corrections reportedly spent $66 million on these drugs last year, compared with $47 million in 2014.

Common sense criminal justice reforms will help Wyoming avoid the looming fiscal nightmare that threatens other states. They will make it easior sick individuals to exit our criminal justice system and access less costly medical treatents outside of prison.