A committee at the state legislature voted down a bill on Tuesday that would have limited the amount people incarcerated in state prisons are required to pay for healthcare by capping medical co-pays and waiving them altogether for prisoners with less financial resources.

The 5-5 vote — short of the majority required to advance the measure — by the House Committee on Administration of Criminal Justice means House Bill 175 will not move on to the full House for consideration. Legislators voted it down in spite of a compromise reached between its sponsor, Rep. Mandie Landry, Democrat of New Orleans, criminal justice reform advocates working with Landry, and the Louisiana Department of Public Safety and Corrections, which had initially objected to the bill. 

But in spite of the bill’s failure to advance past committee, it is still possible that the changes sought by Landry could be implemented independently by the DOC through changes to internal regulations. Current law only allows for co-pays — it does not require them. A spokesperson for the department did not immediately respond to a request for comment on whether or not corrections officials planned to make the regulatory changes. 

Currently, DOC requires prisoners to make co-pays for various medical treatments in state prisons. Those run anywhere from $3 for a sick call, $6 for an emergency visit, and $2 for a prescription, according to a report by Loyola University, LSU, and Voice of the Experienced. But because prisoners can make as little as a few cents an hour for work they do while incarcerated, and some receive little or no outside financial support from families, advocates argue that the co-pays can put barriers on who has access to healthcare while locked up. 

Initially, Landry’s bill would have eliminated medical co-pays for people incarcerated in state prisons altogether. When it was first heard earlier this month, however, representatives from the Department of Corrections said that while they understood the problems with co-pays, they were concerned that eliminating them altogether could lead to some prisoners abusing the free access and overwhelming the limited medical staff at state facilities. 

But, in the following weeks, Landry and the department reached a compromise. They agreed that co-payments would be capped at $2, eliminated altogether for prescriptions, and waived the payments for any prisoner with less than $200 in their account. 

At the committee hearing on Tuesday, Natalie Laborde, an attorney with the DOC, said the compromise bill was something that long-time DOC Secretary James Leblanc was in support of. And the bill would only have applied to people incarcerated under the direct supervision of DOC. While about half of state prisoners are held in local jails across Louisiana, the legislation would have only applied to state-run prisons. 

“DOC not only just worked with us, these were their suggestions to make the process fair,” Landry told the committee on Tuesday. “And this would apply to their facilities. They’re the ones who know better, and I do respect their opinion on this.”

According to the acting committee chair, Rep. Tony Bacala, nineteen people in attendance at the meeting submitted cards in favor of the bill. There were none in opposition, and no lawmakers voiced any concerns about the legislation. But when it came time to move the bill favorably as amended, Rep. Debbie Villio objected. When a vote was taken, there were five representatives in favor and five opposed, meaning the bill would not move to the house floor. 

Following the vote, Landry said in a statement she was “shocked that the committee would not pass a common sense bill that was made better by the Department of Corrections.”

“It makes me wonder what is going on with that committee,” she said.

The criminal justice committee has been a source of contention at the legislature recently. Throughout the session, it has been operating without an appointed chair  after former chair, Rep. Ted James, left the legislature to take a post with the federal Small Business Administration. House Democrats say that House Speaker Clay Schexnayder should appoint another Democrat to fill the post, in exchange for votes he received for his leadership position, but he has yet to do so. 

That means the acting chair is Rep. Bacala, a former Ascension Parish Sheriff’s deputy. And with the committee consisting ten Republicans, two Democrats, and an independent, it has not been friendly to reform groups hoping to reduce the state’s reliance on incarceration. (Bacala, however, voted in favor of Landry’s co-pay bill on Tuesday.) But even so, some were taken aback that the committee even failed to move forward with a bill that prison officials actually supported.

Bruce Reilly, Deputy Director of Voice of the Experienced, said it was “surprising that five legislators would oppose a bill agreed upon by the DOC and advocates.”

“I’ve never seen that happen,” he said. 

Medical co-pays are common in prison systems throughout the country. According to the Prison Policy Initiative, Louisiana is one of 40 states that require them. But a number of criminal justice reform groups — including PPI — argue that co-pays disincentivize prisoners from getting necessary preventative care, and can end up causing worse individual and public health outcomes.

Last year, a federal judge ruled that the inadequacy of healthcare at the state’s largest prison, Louisiana State Penitentiary at Angola, violated constitutional protections against cruel and unusual punishment. In her opinion, Middle District of Louisiana Judge Shelly Dick said that prisons policy of requiring co-payments was not in itself unconstitutional, she said that they were “one factor that contributes to a delivery system that is, in this Court’s view, woefully inadequate.”