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Maine has won federal approval for a Medicaid waiver that could dramatically lower the cost of addiction and mental health treatment for people in jail and expand Medicaid rehab coverage statewide.
For people who cannot afford treatment, the change matters in two ways. It relieves strained county jail budgets and, more importantly, it connects incarcerated people to care before release from jail or prison.
Who Qualifies Under the New Waiver
The U.S. Centers for Medicare and Medicaid Services approved Maine’s request on September 25. Under the Section 1115 waiver, correctional facilities can bill MaineCare, the state’s Medicaid program, for certain medical and behavioral health services provided up to 60 days before an adult’s release, and up to 90 days before release for young people in youth correctional facilities.
Maine now joins 21 states and the District of Columbia with similar re-entry waivers.
Federal law normally bars Medicaid from paying for health care for incarcerated people, leaving jails to foot the entire bill.
A bipartisan law passed during the first Trump administration gave states the ability to seek re-entry waivers, and Gov. Janet Mills signed Maine’s application into law in July 2023.
The application process took a year and a half and drew input from all 15 county-run jails, the Maine Sheriffs Association, and the Department of Corrections.
What Medicaid Rehab Coverage Will Pay For
Eligible services under the waiver include medications for opioid use disorder such as buprenorphine and naloxone, case management, HIV and Hepatitis C treatment, and family planning. Correctional facilities can also bill MaineCare for a 30-day supply of a person’s prescription medications to be provided at release.
“This will make it easier when someone leaves to have access to medications and easier for them to see a doctor because those connections to services will start prior to release,” said Vikki Wachino, executive director of the Health and Reentry Project, a national group focused on re-entry health policy. Her organization launched a technical assistance center to help states implement similar waivers.
How Jails Will Pay for Treatment
County officials have described health care costs as an escalating burden. Maine jails spent more than $12.6 million on addiction and mental health treatment last year, according to a January report from the County Corrections Professional Standards Council, the first time the figure had been tallied statewide.
Jails have been required to provide medication-assisted treatment since a 2019 ruling, but officials say they have scraped together funding year after year, often leaning on temporary sources such as opioid settlement funds.
“This is good news,” Somerset County administrator Tim Curtis said of the approval. “This is beneficial to the county taxpayer but most of all it’s beneficial to the inmate that needs certain services and coverage.”
How to Access These Resources
The waiver is approved, but implementation will take time. The state has 120 days to submit an implementation plan to the federal government, and officials expect correctional facilities to begin billing MaineCare on July 1, 2028, though each county jail’s timeline will vary.
[blcokquote]MaineCare medical director Dr. Courtney Pladsen called the change one of the largest shifts in the criminal-legal system in 30 years.[/blockquote]The practical challenges are real: most jails lack electronic health record systems and will need new technology and billing capacity. Officials plan to work with each county individually rather than impose a uniform rollout, since what works in Aroostook County may not work in Cumberland County.
Finding Affordable Treatment in Maine
If you or someone you love is incarcerated or recently released in Maine, this waiver means treatment connections can start before release day.
Outside the justice system, MaineCare covers rehab and behavioral health services for eligible residents, and free and low-cost rehabs in Maine serve people without insurance.
Check whether you qualify for MaineCare, or call
800-914-7089
(
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to find affordable care in Maine.
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