By Rachel Crumpler
NC Health News
Prisons are constitutionally mandated to provide health care to incarcerated people, but that doesn’t mean it has to be provided for free.
And in North Carolina — along with almost 40 other states — the costs can add up when prison systems charge incarcerated people a copay for select health care services.
The N.C. Department of Adult Correction charges $5 for medical and dental services that are initiated by an incarcerated person and $7 for a self-declared emergency visit, according to the prison system’s copay policy. The fee is not charged if staff determine that an actual emergency occurred.
While these fees may seem small, advocates say they can be a financial barrier in the context of low prison wages, leading some people to delay or even avoid care.
In fiscal year 2022-23, 90 percent of incarcerated people assigned to work programs, worked inside prison facilities, earning 40 cents to $1 per day. Those who worked for Correction Enterprises earned up to $3 per day.
“I know a lot of people don’t want to call [for medical help] because of the copay,” said Kayla Dillard, executive director of NC-CURE, a prison reform advocacy group. “They’re limited with how much money they get each month, and if they have to do a copay, they have even less.
“You can work all week to get $5.”
Research shows that can be a problem for the health of incarcerated people and people who are trying to reenter society after incarceration — not just in North Carolina, but across the country. And some states are having second thoughts about the policy.
Here to stay
Vera Crump’s son is incarcerated at Randolph Correctional Center. Since he went to prison over four years ago, she said he’s had to request medical care many times and pay the copays. Fortunately, she said, she and her daughter can afford to keep funds in his account, steadily contributing $120 per month so that he doesn’t have to worry about whether to use the money for a medical call, food from the commissary, toiletries or phone calls with loved ones.
But, she said, she knows this isn’t the reality for everyone, and that concerns her.
