What These Programs Actually DoFor decades, federal Medicaid dollars could not pay for most health care delivered to incarcerated people, leaving that cost to counties and states. In 2018, Congress directed federal health officials to work with states on improving care for people leaving custody. 1, the federal law passed last year, requires state Medicaid agencies to implement work requirements, more frequent eligibility checks and budget reductions. What the Louisiana Approval SignalsIn April, Louisiana became the first state approved under the current administration. Apply for Medicaid immediately on release, ask facility staff about naloxone before release, and identify a community provider in advance.