Under a bill signed Wednesday by Gov. Tony Evers, Wisconsin will seek health care coverage from the federal government for certain services for incarcerated people. 

A statement from Evers’ office said that AB 604 — now Wisconsin Act 233 — aims to improve health outcomes and reduce disruptions in care and rates of people committing new crimes. 

As people with substance use disorders return to the community from jail or prison, they are especially vulnerable to dying from an overdose. Supporters of the new law hope it will aid them.

A federal “inmate exclusion policy” limits incarcerated people’s ability to use Medicaid, but under the new law the state will apply for a waiver, taking advantage of an exception outlined by the federal government. 

The Wisconsin Department of Health Services will submit a request for a waiver to conduct a demonstration project to provide incarcerated people with health care coverage for certain services for up to 90 days before release. 

The department will request coverage for case management services, medication-assisted treatment for all types of substance use disorders and a 30-day supply of prescription medications. If the waiver is approved, incarcerated people would have to be otherwise eligible for coverage under the Medical Assistance program in order to qualify. 

As of Nov. 21, 19 states have approved waivers and nine states including Washington D.C. have pending waivers. 

The Wisconsin Department of Health Services must submit the waiver request by Jan. 1, 2027. The department told the Examiner in November that it needed the authority that the bill would provide before it starts work on putting together the details of the waiver. 

‘The care they need to live’

Rep. Shelia Stubbs (D-Madison), one of the lawmakers who introduced AB 604, said in a statement Wednesday that the bill gives incarcerated people “a greater chance of maintaining sobriety, preventing overdose, and remaining healthy after they rejoin the community.” 

The criminal justice advocacy organization WISDOM was among groups that expressed support for the bill. Tom Denk, the co-president of one of WISDOM’s affiliates, said in an emailed statement that this law is very personal to him and called it “a step forward.”

Denk, who was released from prison to extended supervision in 2022, said he’s had friends in and out of facilities and had too many die because of a lack of services. 

He said that “my own struggles, the trauma, and the deaths of some of my best friends are what motivated me to get involved in advocating for a better system.”

“Medications, and access to medical care, will literally save lives,” Denk said. “Too many people don’t have either, when they’ve left facilities.” 

Denk also emailed the Examiner a statement signed by Bev Kelley-Miller, who wrote that she lost her 22-year-old daughter, Megan Kelley, to a preventable heroin overdose. Kelley-Miller wrote that her daughter had an ankle bracelet “but that didn’t stop her from using.” 

Kelley-Miller, who expressed support for AB 604, wrote that substance use disorder is a medical condition and that using substances is not a choice once you are addicted. 

“I wish Megan was still here,” Kelley-Miller wrote. “Since she’s not, I advocate for others to receive the care they need to live.”

A bill that would have offered sentence adjustments for crimes committed when the offender was younger than 18 died in the Wisconsin Senate last week. The measure would have applied to people who received sentences of at least 15 years for offenses that didn’t involve a death and to those sentenced to at least 20 years for crimes that did include a death. It also  would have prohibited a life sentence without parole or extended supervision for youth offenders, and required the consideration of mitigating factors, such as age and maturity, at sentencing. The bill failed to gain traction or a public hearing in the Senate because, according to the lead sponsor, Sen. Jesse James (R-Altoona), there was a lack of clarity about the number of residents in prisons who would be affected. 

At a Feb. 12 event held by the criminal justice reform advocacy group WISDOM near Eau Claire, James told the gathering that information he had originally distributed concerning the number of residents who would be eligible for a sentence adjustment was not accurate, and because of that, he would not call for a public hearing on the bill.

In response to a Wisconsin Examiner request for clarification, a staff person in James’ office said in an email message: “After talking to the Senator to help with more context, I think there was a misinterpretation of what he meant. We received data from DOC (Department of Corrections) that does not necessarily match with data that advocacy groups have been circulating to other members of the Legislature. While we do work with advocacy groups on the bill, we did not provide them their data, so we are not 100% sure where they got it from. The discrepancies between the data our office was giving out versus these advocacy groups caused some confusion about how many individuals this bill would actually help. Given the time frame left in the session with the Assembly being done sooner than the Senate, clearing up the confusion and getting a public hearing in either chamber just did not come to fruition in time.”

Nikki Olson, founder and executive director of the Wisconsin Alliance for Youth Justice (WayJ), represents one of those advocacy groups.

“Sen. James was essentially given a range while WayJ has a specific number,” she said. “Our specific number fits into the range, so I consider his data and ours to be accurate.”

She added, “Sen. James was given two numbers. The number of people who will be impacted. A separate number was given of people that may or may not be impacted. There was data overlap between the two numbers. These two numbers combined means 130ish-300ish people would be impacted. Our number of 253, as of the end of 2024, fits within that range. The range represents a snapshot in time during 2025. Our specific number is a snapshot as of the end of 2024. I would anticipate the change between the two snapshot dates to be minimal and still within the range.”

The Examiner reported in December 2025 on a bill that had been in the works since the 2022-23 session addressing the same focus of youth sentencing. One of the advocacy groups that supported that effort, Kids Forward, estimated the number of residents who could be affected was more than100.

On Friday, lawmakers in the Wisconsin Assembly voted in favor of a bill seeking Medicaid coverage for people in Wisconsin prisons and jails. Supporters hope it will help recently incarcerated people avoid addiction and overdoses. 

Rep. Shelia Stubbs (D-Madison) said her experience working for the Wisconsin Department of Corrections has given her firsthand knowledge about the impact AB 604 will have. She said it will improve access to treatment and case management and ease the financial burden on justice-involved Wisconsinites. 

The bill would give incarcerated people a greater chance of maintaining sobriety and preventing overdose after release from prison, Stubbs said. After a Minnesota study about the causes of death of recently incarcerated people, researcher Tyler Winkelman said that “substance use is clearly the main driver of death after release from both jail and prison.”

Medicaid is prohibited from paying for services provided during incarceration, barring some exceptions involving inpatient services or an eligible juvenile under 21 years old. The National Association of Counties published a toolkit critical of the “inmate exclusion policy,” arguing in part that it unfairly revokes federal health benefits from people who are being detained prior to trial and have not been found guilty.  

The bill would pursue a path offered by the federal government that allows for a partial waiver of the policy. 

The proposal directs the Department of Health Services to request a waiver to conduct a demonstration project; 19 states have approved waivers and nine states including Washington D.C. have pending waivers, as of November 21. 

A waiver would allow for prerelease health care coverage under the Medical Assistance program, which provides health services to people with limited finances, for up to 90 days before release of an eligible incarcerated person. Coverage would be provided for case management services, medication-assisted treatment for all types of substance use disorders and a 30-day supply of prescription medications. 

The bill garnered support from lawmakers from both parties and from WISDOM and EX-Incarcerated People Organizing, groups that advocate for incarcerated people. 

The Assembly’s vote to seek the coverage for incarcerated people comes on the heels of its vote to accept a federal expansion of Medicaid coverage for women for one year after they give birth. 

For the waiver, if the state seeks federal Medicaid coverage for services that are currently funded with state or local dollars, the state has to reinvest any savings in state or local funds. Savings would be invested in programs to increase access to or improve the quality of health care for incarcerated people. 

In the Department of Corrections fiscal estimate, the DOC said that in fiscal year 2025, the agency spent $500,000 on the 30-day medication supply dispensed for incarcerated people pre-release, $300,000 on pre-release medication assisted treatment medications and $3.9 million on the Opening Avenues to Reentry Success (OARS) program. The OARS program supports the transition from prison to the community of incarcerated people living with a severe and persistent mental illness who are at medium-to-high risk of reoffending. 

The agency estimated it may have over $750,000 in potential cost savings if the waiver is approved and implemented. 

Because not all incarcerated people will qualify, the estimate assumes that half of the medication supply and medication assisted treatment medications costs will be reimbursed, as well as 10% of the OARS program costs. There may be other costs DOC can have reimbursed.

AB 604 would require the Department of Health Services to submit the waiver request no later than Jan. 1, 2027. 

The bill now goes to the state Senate. Supporters of the bill include the Wisconsin Medical Society, the National Alliance on Mental Illness Wisconsin, the Medical College of Wisconsin and the Wisconsin Counties Association.