Washington State Recognized for Groundbreaking Reentry Program

The National Association of Medicaid Directors (NAMD) today announced Washington State’s Health Care Authority (HCA) as a recipient of the 2025 Spotlight Award, recognizing the state’s innovative Reentry Demonstration Initiative that provides impactful health care services to individuals leaving incarceration.

Washington State’s HCA launched the initiative on July 1, 2025, making it the second state in the nation, and the first to utilize managed care organizations, to implement a federal Section 1115 demonstration waiver allowing Medicaid payment for services up to 90 days prior to an individual’s release from carceral facilities.

The initiative addresses a gap in care: prior to implementation, individuals had their Medicaid coverage terminated upon incarceration, leaving them without access to vital medications, treatments, and healthcare services during their most vulnerable time after release. Research shows that opioid overdose is a leading cause of death in the immediate period following release from custody.

“We aren’t just launching a program; we are building a safety net for people at their most vulnerable moment. Our purpose was clear from the start: reduce overdose deaths, reduce recidivism, and transform lives,” said Tyron Nixon, Transformation Implementation Manager with Washington State HCA. “What keeps our team motivated through every complex negotiation was remembering why we’re doing this. It’s about the people who will receive the help they need to be successful as they move back into their communities.”

The program’s creative and pragmatic solutions include:

• Building strong partnerships with the Washington Association of Sheriffs & Police Chiefs (WASPC), carceral facilities, tribal partners, and individuals with lived experience
• Phased implementation using three cohorts, allowing facilities to launch at different times based on their readiness to meet program requirements
• Partnership with Managed Care Organizations (MCOs) to ensure post-release care coordination and “warm hand-offs” to community providers
• Capacity building funding to help facilities prepare, varying by facility size and population served

“The creativity, persistence, and person-centered approach demonstrated by the HCA team—from negotiating first-of-its-kind contracts to building bridges between Medicaid and justice systems—sets a remarkable example for states across the country that are at an earlier stage of implementation,” said Kate McEvoy, Executive Director of the National Association of Medicaid Directors. “This initiative shows that with the right partnerships and unwavering focus on the people being served, states can provide impactful services for justice-involved individuals and their communities.”

Eight Washington facilities went live on July 1, 2025, including five county jails in predominantly rural areas, one tribal jail, and two juvenile detention facilities. Four additional facilities launched November 1, 2025, with 11 more planned for January 2026, and 23 facilities committed to a July 2026 launch, totaling 56 facilities across the state.

Early results are promising. During rapid response calls in the first 30 days, facilities reported that individuals are receiving needed treatment and sustained recovery support with successful warm hand-offs to community-based treatment. Facilities also noted increased Medicaid enrollments for individuals who didn’t know they were eligible and highlighted that strong open communication with MCOs has been instrumental to the program’s success.

About NAMD’s Spotlight Award

The National Association of Medicaid Directors’ annual Spotlight Award recognizes exceptional leadership and innovation in Medicaid administration. The 2025 award specifically highlighted achievements that demonstrate excellence in driving value through improved member experience and efficient use of taxpayer resources. Learn more about the other 2025 winners here.