Until recently, jail and prison inmates were excluded from Medicaid coverage, despite their elevated rates of mental and physical illness. Now, as a result of changes in federal law made with overwhelming bipartisan support, Medicaid has begun paying for a narrow set of services beginning up to 90 days before an inmate is released and continuing afterward. Law enforcement and correctional leaders say it represents a seismic shift in how incarcerated people navigate the perilous transition back to freedom, with significant benefits for their health and safety and for the communities they rejoin.