The Business, Entrepreneurship & Tax Law Review

Article Title

Caring for Aging Prisoners is Taxing: How Missouri Can Ease Its Prison Health Care Burden


JoEllen Grohs


In 1976, the Supreme Court of the United States handed down the decision in Estelle v. Gamble which established the government’s obligation to provide medical care to incarcerated persons. The 1970s is also known as the “Tough-On-Crime Era,” where politicians began to take sides on crime and create mandatory minimum sentences. This led to a dramatic increase in the prison population and, more specifically, the aging prison population. Because of the government’s obligation to provide medical care to inmates based on the decision in Estelle, caring for the aging prison population has become more expensive and more burdensome on the taxpayer. Missouri has one of the highest incarceration rates in the world and one of the highest aging prisoner populations. This article examines the high cost of caring for the aging prisoner population nationally and in Missouri and compares methods other states are using to lessen the burden on their taxpayers. In so doing, this article will ultimately conclude that Missouri should expand its medical parole policy or its use of telehealth in prisons to release some of the aging prisoners.