The Omicron surge has led the Pennsylvania Department of Corrections to revert to some of the restrictions used earlier in the pandemic, like ending in-person family visits. But even as the variant has infected thousands of people in custody and killed them at the highest rate since last winter, the DOC did not adjust another policy it earlier had found could hinder prisons’ efforts to prevent an outbreak—the $5 copay for medical visits.

There’s no place for copays in the “new normal”

Shortly after Acting Secretary of Corrections George Little took control of the DOC last fall, he declared it was time for prisons to move “back to our new normal” and undid a policy suspending all medical copays that had been in effect for most of the year. He reinstated the DOC’s older pandemic policy of waiving copays only for people complaining of flu-like symptoms, which the Prison Society found was applied inconsistently and the former corrections secretary admitted had deterred some incarcerated people from reporting possible COVID-19 symptoms.

The Omicron surge has shown how premature this return to “normal” was. But Acting Secretary Little is right that prisons should move toward a “new normal” that looks different from the old one. Public health experts say we must prepare for a future in which we never fully eradicate the coronavirus and it becomes an endemic threat like the flu. That means enacting proactive policies to prevent and mitigate future outbreaks. For prisons, permanently eliminating medical copays across the board should be a basic part of the plan.

The president of the American College of Correctional Physicians, Charles Lee, agrees. "Covid will be better managed if there are no copays,” he tells the Prison Society. Lee, who was the medical director at a California state prison for 10 years and now works as a consultant assessing medical services in prisons and jails across the country, added that eliminating copays would also be better for the “overall good of patient care.”

“That’s the bottom line in medical—see the patient, take care of the patient,” Lee says.

Unfortunately, the Pennsylvania DOC is relying too heavily on a different metric to guide its policymaking. The department cites a 30% decrease in medical visits since copays were reinstated last fall to justify the fees, arguing that this shows how the copay keeps incarcerated people from seeking unnecessary care. But the reality that formerly incarcerated people have recounted time and time again is that the DOC’s $5 fee is a prohibitive cost to health care that they desperately need. Wages for the jobs they work in Pennsylvania state prisons range from $0.19 to $0.51 an hour, and they have to stretch these meager earnings to cover additional expenses like phone calls to family, food from commissary, and toiletries.

As Lee points out, if only one patient among those 30% who the DOC says were deterred by the copays turned out to be infected with the coronavirus, that person could go on to infect others, leading to an outbreak and even deaths that could have been avoided. “I think they’ve got to take that into consideration,” he says.

The Prison Society calls on the Pennsylvania Department of Corrections to restore its previous pandemic policy suspending all medical copays. We also call on state lawmakers to pass legislation to eliminate the copays permanently in state prisons.

Help us end medical copays: share your stories

We have heard countless stories from incarcerated people and their families about how medical copays undermine health behind bars. Now, Governor Wolf, lawmakers, and the Department of Corrections need to hear them too to know how serious this issue is. The Prison Society and FAMM are collecting these stories to use in our campaign to eliminate the copay.

What has been your family’s experience with the prison medical copay? Share your story here: https://forms.gle/h4Ysn4jp77QM9aFQ6

The Prison Society once again calls on all state and county officials to:

• Eliminate the medical co-pay for accessing health care while in custody;
• Expand efforts to safely reduce the number of people in custody;
• Continue to offer COVID-19 vaccinations and booster doses to all people in custody and staff in prisons and jails;
• Implement weekly, rapid testing of all staff that come into contact with people in custody until they are vaccinated;    
• Require that every county publicly report prison testing results and virus-related deaths in custody;
• Test and quarantine every new person entering custody; and
• Provide highly-protective N95 or KN95 respirators to people in custody.

If you have questions about COVID-19 in Pennsylvania prisons, visit our COVID-19 landing page or email customerservice@prisonsociety.org.

We’re here to help.