Viagra for sex offenders?

In 2003 forty five million Americans could not obtain, did not choose to purchase or simply could not afford health insurance. That’s 15.6 percent of the United States population. Some of these people may be here illegally but most likely they are decent, hard working Americans who were priced out of the health insurance market. Too young to retire they are not eligible for Medicare. And apparently they are not destitute enough or cannot meet some of the weird criteria in order to qualify for Medicaid provided by their state.

But if they had been convicted of a serious crime at least their health insurance would be paid for. Admittedly it might not be much fun being in prison, and just evading rape can be a full time occupation. In the state of Virginia where I live and in many other states, when prisoners have served their sentence and are released to the community they usually qualify for Medicaid coverage paid for by the State. So crime seems to pay, or at least ensures that for a while you will receive free or heavily subsidized medical care.

But did you know that until very recently that if you suffered from erectile dysfunction and were a registered sex offender you could receive Viagra on the taxpayer’s dime? Sadly, I am not making this up. According to a survey by the Associated Press, here in Virginia and in 13 other states Medicaid paid for 788 sex offenders to receive drugs for treating impotence.

Silly me. I assumed that Medicaid administrators in these states had some lick of common sense. Some of these Medicaid administrators claim a 1998 Clinton Administration Medicaid policy by inference allowed sex offenders to receive these drugs. A letter sent to certain states by the federal government required Medicaid to pay for all legal FDA approved drugs with a few limited exceptions. Apparently erectile dysfunction wasn’t on the exceptions list. But that letter also said that restrictions could be put in place to cover abuse. I would hope this issue was simply overlooked by these state Medicaid administrators. But at a minimum it suggests officials in these fourteen states were asleep at the wheel.

This is not hard to figure out. No we certainly don’t want to do anything that would make it easier for proven sex offenders to potentially have more victims. And we sure don’t want to do it on the taxpayer’s dime. So of course we don’t want to subsidize these costs for registered sex offenders. My governor Mark Warner was one of the governors figuratively caught with his pants down. He issued an emergency order to prohibit future prescriptions of these drugs to registered sex offenders by the Commonwealth.

In my opinion as a condition of probation registered sex offenders should be required to take drugs that actually cause impotence. There are a number of them out there, and certain antidepressants actually have impotence as side effect. In addition to frequent checkups from their parole officers, sex offenders out in the community should be getting therapy to reduce the likelihood that they will sexually assault anyone again. Indeed the mayor of Miami has proposed a new ordinance that prohibits registered child sex offenders from going to certain places like public parks where children are present.

Miami’s proposed ordinance is a sad but necessary policy that I would like to see in other communities. I would like to hope that even a sex offender could be rehabilitated. However when it comes to crimes that tend to profoundly affect the victim for the rest of their life, such as serious sexual, physical or emotional abuse, it is completely reasonable for society to insist that registered sex offenders have their privileges sharply limited, providing they are released back into society at all. This should be a two strikes and you are out crime. A second offense should require these offenders be locked up again for the rest of their lives.

I hope that state Medicaid administrators use this opportunity to review their implementation of the federal Medicaid statutes so egregious actions like this do not recur.