Cody Coughenour of Port Angeles, Wash.is a beneficiary of a bipartisan policy experiment that allowed him to receive Medicaid before being released from incarceration.
Ramon Dompor for Tradeoffs hide caption Stay up to date with our Up First newsletter, sent every weekday morning.Cody Coughenour landed in jail at least half a dozen times by the time he was 47 years old.First, it was crimes related to his alcohol addiction.
Then, when he was 26 years old, his mother died of a meth-induced heart attack.The overwhelming grief led him to the same methamphetamines that killed his mother."What people are running away from, that's what they're going to run into," he said.Each time Coughenour got out of jail in Washington state, the list of things he was supposed to do to get back on his feet felt overwhelming.He knew that addiction treatment and therapy should be near the top.But to pay for that care, he needed health insurance.When he would get released, his jailers would hand him a phone number to call to get onto Medicaid, the public health insurance program for low-income and disabled Americans.
It would either go to voicemail, Coughenour said, or he'd be placed on a long hold.That delay was enough to send him straight to his dealer's house — and eventually back to jail.December 2025 was different.
Coughenour left jail with medications for his anxiety, his Medicaid card in hand and appointments already on the calendar."We went straight to the treatment facilities," he said.Coughenour's experience is one example of a much larger experiment unfolding across the country.Some states are turning Medicaid on before some people leave jail or prison, with the goal of making sure they have a better chance of staying out of jail and staying alive.But just as 19 states race to build these programs, Medicaid itself is changing.H.R.
1, the sweeping fede...