Lesson plan; Why is health care out of reach for people released from prison in the USA?


This lesson is part of our Searching for Justice series on criminal justice reform. PBS

Are you looking for a way to engage your students in a meaningful discussion about criminal justice reform and health care access? Do you want to help them develop critical thinking, research, and writing skills while exploring a timely and relevant topic? If so, you might want to try this lesson plan based on the Searching for Justice series from The Marshall Project.

Warm-up activity

Choose: Have the class watch PBS Newshour’s Laura Santhanam’s interview with Tradeoffs producer Ryan Levi or take turns reading aloud the transcript of this episode of Tradeoffs and talk about the following paragraph:

But [Lee Reed’s] pain continued to get worse. The constant agony and Reed’s inability to support himself took a toll on his mental health, occasionally making him wonder if his life was worth living.

  • Discuss: What are some systemic causes for Reed’s declining mental health?

Read this text

When someone is released from prison, they often must rebuild their whole life from scratch while lacking basic government identification, a stable income, or access to housing and health care.

A 2007 study, published in the New England Journal of Medicine with data from Washington State, found that people leaving incarceration were 12 times more likely to die during the first two weeks after release than non-incarcerated people. Drug overdoses, cancer, cardiovascular disease, homicide, and suicide are some of the most common causes.

To eliminate coverage gaps, some states are working to let people leaving prison more easily get the health care they need. In January, California began offering Medicaid to people up to 90 days prior to their release from incarceration.


By the end of this lesson, students will be able to:

  • Understand what conditions many face after their release from jail or prison.
  • Grasp, critique, and debate recent and proposed Medicaid expansions to the incarcerated.
  • Outline an explainer news package based on the lesson.


  1. Warm-up: Ask students to brainstorm what challenges someone might face after being released from jail or prison. Write their responses on the board or chart paper. Then, ask them to think of what resources or support they might need to overcome those challenges. Write their responses in a different color or column.
  2. Introduction: Tell students that they are going to learn about how some states are trying to improve healthcare access for people leaving incarceration. Explain that health care is one of the most important and urgent needs for many formerly incarcerated people but also one of the most difficult to obtain. Ask students why they think that might be the case. Elicit some possible reasons, such as lack of identification, income, insurance, transportation, stigma, discrimination, etc.
  3.  Reading:  the article “California Expands Medicaid to People Leaving Prison” by Keri Blakinger. Have students read it individually or in pairs. Alternatively, you can read it aloud as a class or play the audio version from the website. As they read, have them underline or highlight any key facts or arguments that support or oppose the Medicaid expansion.
  4. Discussion: After reading, have students share their reactions and opinions about the article.

Discussion topics

  • What is Medicaid and how does it work?
  • What are some of the benefits and drawbacks of expanding Medicaid to people leaving prison?
  • How does California’s policy compare to other states’ policies on this issue?
  • What are some of the challenges or barriers that might prevent people from accessing or using Medicaid after release?
  • How might Medicaid expansion affect public health, public safety, and public spending?
  • What are some of the ethical or moral implications of providing or denying health care to formerly incarcerated people?
  • What are some of the alternative or complementary solutions that could address the health care needs of reentry populations?

Group work:

Divide students into small groups of 3-4. Assign each group a role: reporter, editor, producer, or graphic designer. Tell them that they are going to work together to create an explainer news package based on the article and the lesson. An explainer news package is a type of journalism that provides background information, context, analysis, and visuals to help audiences understand a complex topic or issue. Explain that each role has a different task and responsibility:

Reporter: Write a script for a short video (3-5 minutes) that summarizes and explains the main points of the article and the lesson. Use clear language, examples, and evidence to support your claims. Include an introduction, a body with subheadings, and a conclusion.
Editor: Review and revise the script for accuracy, clarity, coherence, and style. Check for spelling, grammar, punctuation, and word choice errors. Make sure the script follows journalistic standards and ethics.
Producer: Plan and record the video using a smartphone, camera, or computer. Choose an appropriate location, lighting, sound, and background for the video. Use props.

Essay questions

  • How does lack of health care access affect the lives and well-being of formerly incarcerated people? Use examples from the article and the lesson to support your answer.
  • What are the benefits and challenges of expanding Medicaid to people leaving prison? Compare and contrast the perspectives of different stakeholders, such as policymakers, health care providers, and formerly incarcerated people.
  • How would you explain the issue of health care access for formerly incarcerated people to a general audience? Use the worksheet to outline an explainer news package that includes a headline, a lead, a hook, and a call to action.

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