In an issue brief, for the Commonwealth Fund, COCHS' former CEO Vikki Wachino, Dan Mistak, and Natasha Camhi describe the health care needs of people involved in the justice system, how Medicaid’s role in providing coverage for this population has evolved to address those needs, and new policy changes that states and the federal government are advancing. Several factors are driving efforts to strengthen health care for people who spend time in jails and prisons or are otherwise involved with the criminal justice system. These include the impact of COVID-19 behind bars, the need to address the country’s mental health and substance use crises, and interest in helping people successfully rejoin their families and communities after they are released from prison or jail.