美国国家公共电台 NPR Signed Out Of Prison But Not Signed Up For Health Insurance

Signed Out Of Prison But Not Signed Up For Health Insurance

play pause stop mute unmute max volume 00:0005:00repeat repeat off Update Required To play the media you will need to either update your browser¹ to a recent version or update your Flash plugin. RACHEL MARTIN, HOST: 

Prisons are full of people dealing² with serious health problems. Mental illness, addiction³ and other diseases are rampant⁴ in the correction system. Inmates⁵ can get treatment while they're incarcerated⁶, but getting out often means losing health care. Some states are trying to get released prisoners under Medicaid, but many ex-inmates are still left out. Jake Harper of Side Effects Media - Side Effects Public Media spoke⁷ with one man in Indianapolis.

JAKE HARPER, BYLINE⁸: Ernest takes two drugs - lithium and an anti-psychotic.

ERNEST: Well, I suffer from manic depression. And I - what caused my crime was an acute severe psychotic episode.

HARPER: He's been trying to find a job. That and his crime are why he asked us to use just his middle name. In 1991, Ernest killed his 2-year-old daughter. He thought God would stop him, like in the story of Abraham. The medication he got in prison stabilized⁹ him, and he served 24 years. Before he was paroled, he tried to get his insurance set up. It didn't work.

ERNEST: You know, I don't have a job. I don't have any money. How can I buy medication?

HARPER: He got out of prison with a 30-day supply of his meds, unsure how he would get a refill. He worried about another psychotic episode, about hurting someone.

ERNEST: I made some impassioned calls to people saying, hey, I'm about to run out here, and it's very important because my whole world comes crashing down if I'm not mentally stable. You know, if I don't get this medication, then there's - there's going to be some problems because I'm - you know, I'm mentally ill. And so, for me, that was my main concern.

HARPER: Ernest should have left prison with Medicaid. Under Obamacare, 31 states have expanded Medicaid to cover most low-income adults, including ex-prisoners. The Medicaid expansion may or may not survive Republican promises to change Obamacare. But for now, if you get out of prison or jail in one of those 31 states...

DAN MISTAK: You know, it's slim chances that you wouldn't qualify for Medicaid.

HARPER: Dan Mistak says prisons and jails can sign people up for Medicaid while they're incarcerated, suspend it and then activate¹⁰ it once they get out. Mistak is an attorney at Community Oriented Correctional Health Services, and he says some states, like Colorado and California, are doing that.

MISTAK: But that is - that is not the practice across the country.

HARPER: In an investigation¹¹, Kaiser Health News and the Marshall Project looked at how prison systems across the U.S. are dealing with this. Beth Schwartzapfel is a reporter with the Marshall Project.

BETH SCHWARTZAPFEL: What we found is a really mixed bag.

HARPER: The Federal Bureau of Prisons in 16 states have no procedures to enroll¹² inmates before release. And nine states only enroll certain prisoners, such as those with disabilities.

SCHWARTZAPFEL: And then the remainder of the states are making a good-faith effort. There's just so many ways that people can fall through the cracks.

HARPER: For instance, Indiana has a system to apply for Medicaid on a prisoner's behalf, but the Marshall Project found that some of those released were left out, people like Ernest. The situation is more uncertain in local jails, where rates of mental illness are even higher. The ones that do enroll people in Medicaid come up with their own process.

DEBBIE SULLIVAN: Who else needs paperwork?

HARPER: Lieutenant¹³ Debbie Sullivan asks inmates to fill out Medicaid applications at the Marion County Jail in Indianapolis. She yells through the bars to a cell block of about a dozen women.

SULLIVAN: Ladies, on that second page, it's going to ask for your first and last name and the last four of your Social Security number and your date of birth.

HARPER: Handing out applications is step one, but a lot can still go wrong. Leaving prison or jail is a chaotic¹⁴ time. Ex-inmates need a place to live, a job, transportation. Indiana prison data show that only about half of released inmates follow up, and even fewer go on to actually get coverage¹⁵. Part of Sarah Barham's job is to help mentally ill clients sign up for Medicaid. She works as a recovery coach in Indianapolis.

SARAH BARHAM: It can very much be a nightmare.

HARPER: Even when she's there to help, it's overwhelming, especially when someone's supply of medication disappears.

BARHAM: It's like a train wreck¹⁶. You're just watching it. And so they get out in the community with all the other barriers and stressors they have, and now suddenly they're pulled off their medication cold turkey and expected to just hang in there.

HARPER: Ernest did manage to hang in there, but just barely. A local clinic filled a prescription¹⁷ for free.

ERNEST: Just, like, at the last minute, somebody managed to get things taken care of so that I was actually, you know, supplied with medication.

HARPER: Then, finally, he got Medicaid. He says he was lucky. But given his condition, he says it wasn't something that should have been left to chance. For NPR News, I'm Jake Harper.

MARTIN: For more on this investigation, go to npr.org. This story is part of a report - reporting partnership¹⁸ with the Marshall Project, Kaiser Health News and Side Effects Public Media.

1 browser   

n.浏览者

参考例句：

• View edits in a web browser.在浏览器中看编辑的效果。
• I think my browser has a list of shareware links.我想在浏览器中会有一系列的共享软件链接。

2 dealing   

n.经商方法，待人态度

参考例句：

• This store has an excellent reputation for fair dealing.该商店因买卖公道而享有极高的声誉。
• His fair dealing earned our confidence.他的诚实的行为获得我们的信任。

3 addiction   

n.上瘾入迷，嗜好

参考例句：

• He stole money from his parents to feed his addiction.他从父母那儿偷钱以满足自己的嗜好。
• Areas of drug dealing are hellholes of addiction,poverty and murder.贩卖毒品的地区往往是吸毒上瘾、贫困和发生谋杀的地方。

4 rampant   

adj.(植物)蔓生的；狂暴的，无约束的

参考例句：

• Sickness was rampant in the area.该地区疾病蔓延。
• You cannot allow children to rampant through the museum.你不能任由小孩子在博物馆里乱跑。

5 inmates   

n.囚犯( inmate的名词复数 )

参考例句：

• One of the inmates has escaped. 被收容的人中有一个逃跑了。 来自《简明英汉词典》
• The inmates were moved to an undisclosed location. 监狱里的囚犯被转移到一个秘密处所。 来自《简明英汉词典》

6 incarcerated   

钳闭的

参考例句：

• They were incarcerated for the duration of the war. 战争期间，他们被关在狱中。 来自辞典例句
• I don't want to worry them by being incarcerated. 我不想让他们知道我被拘禁的事情。 来自电影对白

7 spoke   

n.（车轮的）辐条；轮辐；破坏某人的计划；阻挠某人的行动 v.讲，谈（speak的过去式）；说；演说；从某种观点来说

参考例句：

• They sourced the spoke nuts from our company.他们的轮辐螺帽是从我们公司获得的。
• The spokes of a wheel are the bars that connect the outer ring to the centre.辐条是轮子上连接外圈与中心的条棒。

8 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

9 stabilized   

v.（使）稳定， （使）稳固( stabilize的过去式和过去分词 )

参考例句：

• The patient's condition stabilized. 患者的病情稳定下来。
• His blood pressure has stabilized. 他的血压已经稳定下来了。 来自《现代英汉综合大词典》

10 activate   

vt.使活动起来，使开始起作用

参考例句：

• We must activate the youth to study.我们要激励青年去学习。
• These push buttons can activate the elevator.这些按钮能启动电梯。

11 investigation   

n.调查，调查研究

参考例句：

• In an investigation,a new fact became known, which told against him.在调查中新发现了一件对他不利的事实。
• He drew the conclusion by building on his own investigation.他根据自己的调查研究作出结论。

12 enroll   

v.招收；登记；入学；参军；成为会员（英)enrol

参考例句：

• I should like to enroll all my children in the swimming class.我愿意让我的孩子们都参加游泳班。
• They enroll him as a member of the club.他们吸收他为俱乐部会员。

13 lieutenant   

n.陆军中尉，海军上尉；代理官员，副职官员

参考例句：

• He was promoted to be a lieutenant in the army.他被提升为陆军中尉。
• He prevailed on the lieutenant to send in a short note.他说动那个副官，递上了一张简短的便条进去。

14 chaotic   

adj.混沌的，一片混乱的，一团糟的

参考例句：

• Things have been getting chaotic in the office recently.最近办公室的情况越来越乱了。
• The traffic in the city was chaotic.这城市的交通糟透了。

15 coverage   

n.报导，保险范围，保险额，范围，覆盖

参考例句：

• There's little coverage of foreign news in the newspaper.报纸上几乎没有国外新闻报道。
• This is an insurance policy with extensive coverage.这是一项承保范围广泛的保险。

16 wreck   

n.失事，遇难；沉船；vt.(船等)失事，遇难

参考例句：

• Weather may have been a factor in the wreck.天气可能是造成这次失事的原因之一。
• No one can wreck the friendship between us.没有人能够破坏我们之间的友谊。

17 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

18 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。