The bill was called “Build Back Better” because giving bills cool names has proven more effective in getting public support than actually “selling” the public on what the bill does. Remember the USA PATRIOT Act?* And who doesn’t want to build back better, because building back worse, or not building back at all, sounds horrible. But as becomes clear in the years after a law is enacted, what exactly was done may neither be what the name suggested nor what works.

The efficacy of omnibus bills, proposed laws that cover and broad swathe of unrelated or quasi-related programs, spending and prohibitions, is obvious. The less we know about what’s in there, the fewer things we find to criticize. And it plays the parts we like against the parts we don’t, the parts that seem like a good idea against how that seemingly good idea will actually happen. As hard as it may be to come up with an agreeable law addressing a specific problem, with the right focus, words, execution and funding, it’s far harder to do so when there are a hundred laws folded into one omnibus law.

At the same time, a phenomenon occurs when we’re talking about a huge omnibus law that allows us to discuss the law as some overarching good or evil and shrug off the details of the law as if they are insignificant. In a weird way, it’s reminiscent of Stalin’s “one death is a tragedy, a million is a statistic.”

In the BBB bill, there were a few aspects that were elevated to the forefront, like child care and climate change. Of course, it’s not as if child care was without controversy, or there is an obvious climate change fix that everyone agrees about. These are big issues, popular issues, even if the nuts and bolts evades some scrutiny. But what about the Medicaid Re-Entry Act?

Each year, more than 650,000 people are released from state and federal prisons. Nine million others churn through local jails. For many, the transition back to the outside world poses an acute risk. Studies have shown a decline in the health of the recently released, who experience significantly higher rates of death and hospitalization compared to the general populace. The first two weeks can be especially dangerous.

As criminal defense lawyers, we know where this is going, even if it gets buried for the benefit of NYT readers.

Multiple factors are fueling this tragedy. The incarcerated population already suffers from disproportionately high rates of physical and behavioral health problems, from hypertension and asthma to mental illness and substance abuse disorders. While effective treatment options can be hard to come by behind bars, returning to the community can be even bumpier, resulting in dangerous disruptions in care. People suddenly find themselves without the medication they desperately need to survive, be it insulin or antipsychotic drugs. Many face barriers to care including homelessness, unemployment and a lack of social support systems. The newly released are unusually susceptible — physically and psychologically — to overdoses.

Did you know this was in there? Maybe you did, but I didn’t. Go figure.

General unhealthiness aside, because prison isn’t well-regarded for the healthiest of environments, there are two huge medical problems that have long been known as prisoners transition out: Mental illness and overdose. Both have significant ramifications for both public safety and individual survival. Neither has an easy fix.

The Medicaid Re-entry Act, one of the many policy proposals thrown into limbo with the collapse of the Build Back Better Act this weekend, seeks to smooth this transition. The legislation would clear the way for states to use Medicaid to provide coverage for inmates up to 30 days before the inmates’ scheduled release.

Whether this is the right way to address these issues is worthy of some serious discussion. There are collateral issues, such as who pays for unfunded federal mandates like this and whether they deal with the causes or are merely a band-aid to cover the open wound. For  mentally ill prisoners in need of medication, there is little doubt that they need immediate access if they’re not to fall into oblivion, live in cardboard boxes and harm people in psychotic episodes. But we can’t make them take the drugs after they’re released, and too often, they don’t want to or their mental illness prevents them from exercising the sane discretion to remain properly medicated.

As for overdoses, release from prison has long been an opportunity to get that fix for which one yearned. Drug rehab in prison is, or should be, readily available, but it either isn’t really or it’s just a scam. Someone who doesn’t want to be rehabilitated won’t be, and when they come out, the streets offer a smorgasbord of highs. Controlling oneself when it comes to getting that long-awaited fix is not always a prisoners’ strong suit. So they OD. A lot.

But we’re not having this discussion about the Medicaid Re-Entry Act, not because it’s unworthy of discussion or unimportant.

The bill is relatively modest in its aims. Mr. Tonko has stressed that it would not expand Medicaid eligibility. Neither does it seek to abolish the inmate exclusion provision wholesale, as some groups favor. Even so, it would cost money, and talk of providing any benefits to inmates can be politically tricky. As is often the case, the provision’s best bet is to get folded into a much larger legislative package. Proponents were hoping to attach it to the Covid relief bill that passed this year, to no avail.They then folded into Build Back Better.

Rather than propose this as a stand-alone bill, a public good worthy of enactment or not, it’s buried, or euphemistically “folded” into another bill, so it might happen under the radar where nobody will notice that it involves public cost for the sake of a “warm handoff” of prisoner, not always a beloved cohort, to the Medicaid system after release.

Elsewhere, this bill might be less appreciated than it is among those of us who practice criminal law, who know these people and appreciate how much we want them to succeed in life after completing their sentence. Maybe it’s wise to hide it from the groundlings who are disinclined to waste a dime on the nuts and bolts ex-cons’ transitional survival even as they gush empathy for free on social media. But until now, who knew this was even in the bill?

*The actual name of the law is the “Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism” Act.