Arkansas charges inmates medical co-pay
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Almost all states, including Arkansas, allow jails and prisons to charge incarcerated people medical and "room and board" fees, locking them into cycles of debt and possibly more incarceration, a recent Axios review of new data found.
Why it matters: The debt wheel targets the majority of the estimated 1.8 million people in state prisons and local jails, putting up more obstacles to escaping the poverty that likely contributed to arrests in the first place.
The big picture: The fees raise hundreds of millions of dollars for victims' funds, DNA databases and other programs, but also help states expand efforts to incarcerate more people.
- Unlike other taxpaying constituents, introducing or raising fees on incarcerated people is rarely met with resistance.
- And some state lawmakers are unaware that the fees exist.
By the numbers: Data collected by the advocacy group Campaign Zero, reviewed by Axios, found that 48 states in the U.S. permit the imposition of at least one category of "pay-to-stay" fees on incarcerated individuals as of December 2024.
- 42 states and D.C. explicitly allow for room and board fees for incarcerated adults, according to a review of statute language that clearly outlined the imposition.
- 43 states explicitly allow for medical fees for incarcerated adults.
- 33 states and D.C. explicitly allow for room and board fees for incarcerated youths.
- 31 states and D.C. explicitly allow for medical fees for incarcerated youths.
Zoom in: The Arkansas Department of Corrections collects a $3 co-pay fee for each inmate-initiated medical visit from both adults and youths, spokesperson Rand Champion told Axios via email. Up to $5 is permitted under the department's code of rules.
- Adult work release inmates who are employed are charged $22 per day — $154 per week — for room and board. About 900 state inmates are now in the work release program.
- Champion said he wasn't aware of any room and board charges for youths.
Inmates performing in-house jobs in Arkansas prisons are not paid any wage, Champion said.
How it works: Pay-to-stay fees are imposed during incarceration and automatically taken from individuals' wages or prison accounts.
- Because many incarcerated people can't fully pay fees while in prison, the costs often pile up as debt they're still expected to repay after their release, Campaign Zero executive director DeRay Mckesson told Axios.
- Mckesson said incarcerated people also are often charged medical co-pays, from $4 to $15, for routine visits that add up since many get paid around $.50 an hour while in prison.
The intrigue: The study did not break down how the fees affected people of color in prisons and jails, but Mckesson said they are disproportionately hurt since they are overrepresented in the criminal justice system.
- Some states, like Missouri, this year have changed some of their laws governing the fees.
What they're saying: "I call it taxing criminal defendants. It's a way for governments to raise revenue without facing any political consequences," New Mexico State Sen. Antonio "Moe" Maestas, a Democrat and a criminal justice reform advocate, told Axios.
- Maestas said the fees have nothing to do with public safety.
Yes, but: Some of the fees charged to incarcerated people involve restitution for victims and the funding of other programs.
- However, some of the fees for restitution for victims are charged to many incarcerated people who've committed "victimless" crimes like drug possession.
Dylan Hayre, who leads advocacy at the nonprofit Fines and Fees Justice Center, which works to eliminate fees in the criminal justice system, said the charges are "financial exploitation disguised as justice."
- "You've taken people at their most vulnerable and handed them a bill they can't pay. That debt destabilizes lives and entire communities," he said.
What we're watching: Campaign Zero is advocating for all states to eliminate the fees and will be visiting various states to present its case.


