Inmates have no right to treatment for hepatitis C: appeals court

The Commonwealth of Kentucky doesn't have to give its prisoners free, potentially life-saving treatment for hepatitis C, a blood-borne disease with many health implications, a federal appeals court ruled in a split decision last week.

The state Department of Corrections wants to deny the treatment "because it is expensive — a decision a dissenting judge says will condemn hundreds of prisoners to long-term organ damage and suffering," reports Andrew Wolfson of the Louisville Courier Journal.

Judge Jane Stranch of Nashville, a Barack Obama appointee, was in the minority of the 2-1 decision by the 6th U.S. Circuit Court of Appeals. The other two judges were appointed by Republican presidents, as was District Judge Greg Van Tatenhove, whose ruling the panel upheld. 

"The majority found that denying it to most of Kentucky’s 1,200 inmates with hepatitis C does not constitute cruel and unusual punishment in violation of the Eighth Amendment" to the Constitution, Wolfson reports.

Ruben Rios Salinas is
an inmate seeking care.
(State photo via CJ)

The treatment "cures nearly 100 percent of patients but costs $13,000 to $32,000," Wolfson notes. The state has a plan to ration use of the treatment for the viral infection, which it says fits U.S. Bureau of Prisons policy. But it is contrary to the policies followed by Indiana and Tennessee, Wolfson notes.

Stranch said by “flouting the recognized standard of care,” the plan “consigns thousands of prisoners with symptomatic, chronic HCV to years of additional suffering and irreversible liver scarring.” Using a long-recognized standard, she said withholding treatment until the damage can't be reversed, the plan “shocks the conscience.”

Barbra Cave, a University of Louisville professor of medicine who leads U of L's hepatitis-C program, said the treatment saves money long-term by reducing the cost of care for illnesses that hepatitis C causes, such as diabetes, lymphoma and liver diseases. That was one of the arguments made by prisoners in a class-action lawsuit.

Their attorney, Greg Belzley, told Wolfson that they would ask for a rehearing by the appeals court or ask the Supreme Court to hear the case. "He said as of August 2019, the most recently available figures, the department has identified 1,670 prisoners as HCV-positive. Only 159 had received any treatment," Wolfson reports.

"The department initially denied treatment to anyone who did not have a clean conduct record for 12 months beforehand, including no positive drug tests, prison tattoos or inappropriate sexual behavior. But with the litigation ongoing, last year it amended the rule to cover only infractions that might compromise treatment."