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DOC: Vermont approved for Section 1115 waiver to start Medicaid enrollment before release; rollout set for January 2026
Summary
Department of Corrections staff told the committee that a Section 1115 Medicaid waiver will allow people leaving custody to begin Medicaid coverage 90 days before release, automating enrollment and enabling access to health and reentry services; DOC said the launch depends on Medicaid IT upgrades.
The Department of Corrections told the Corrections & Institutions Committee that Vermont received federal approval for a Section 1115 waiver allowing Medicaid coverage to begin before release, and the department expects the program to start in January 2026.
Commissioner Ivana described the waiver as permitting enrollment in Medicaid during the 90‑day period prior to release so prison and community providers can establish care plans, prescriptions and other services before an individual leaves custody. She said Vermont was among the first states to win approval and that the change represents a “monumental shift in policy.”
DOC said the waiver will allow the state to reimburse a range of services in that pre‑release period — including health care, reentry services and some probation/parole work — and that federal rules require savings be reinvested in reentry supports. The department told the committee it expects the change to produce state savings because federal Medicaid dollars will cover services that the state previously funded directly.
Operational caveat: DOC emphasized the launch depends on the state Medicaid agency (referred to in testimony as DVHA) upgrading its billing and IT systems; the department said that work is ongoing and is the primary cause of the implementation timeline.
Ending: The committee asked DOC to return with more detailed estimates of projected fiscal impact and operational plans for enrolling eligible people during the pre‑release window.
