Chain Letters 1.1 – Prisons Charge Unpaid Laborers for Healthcare

SUMMARY: An inmate wrote to Black and Pink that he is expected to fund his own healthcare despite having no means of earning money. He is required to work every day but does not earn any wages for his labor. Inspired by this, I researched the details and found what he said was absolutely true, and the specific details and statistics surrounding prison healthcare only make the situation that much more horrifying. 

(See end of page for sources)

Transcript Below:

My name is Gaven, I’ve never been involved in the criminal justice system in any way. I just love writing letters, and I started writing to prisoners in 2017. Everything I learn about the American prison system makes me furious, and I think – hopefully – it’ll make you furious too.

I read a letter someone wrote anonymously to Black and Pink, an organization that supports LGBTQ+ inmates. They printed it in their monthly newsletter (Dec 2018). 

I’ve been in TX prisons for 24 — going on 25 — years. Texas is by far the most oppressive state in the union.

If you believe it’s justice or rehabilitation — then you are a fool.
We work in industries where we manufacture goods that are sold at profit to outside agencies and other countries. We actually make the majority of the non-food items that are sold in our commissary.

Our pay is fictional work and “good time” that in theory should be applied toward early release. But it’s discretionary. Therefore it’s worth nothing more than wasted ink on our time sheet.

If we fail to show up to our job that we’re not paid for, we receive disciplinary. Where we could lose our much-coveted work time or “good time” or lose our privilege to go to commissary and purchase the items we failed to go help manufacture as our punishment. We would be excused from work for being sick if we go to medical and pay a hundred dollar co-pay.

I am a ward of the state, I labor for free, eat gravy as a main course at least three meals a week, and yet I am charged for medical, a medical bill paid by our families because we have no source of income. And the icing on the cake is that we are charged a sales tax on certain items we purchase. That’s taxation without representation.

I was shocked, as I’ve never heard of this before. Prisoners have to pay for their own medical costs, despite not being paid any wages for their work? How is that a real policy? Who expected that to actually work?  So I did a lot of research, and everything I read just pissed me off.

Texas prisons – First visit to a doctor is $100, and that covers your medical visits for the entire year.

Most of the articles discussing it are older, but as of an article from March 2018, the law is still in effect.

According to the official notice of the law from the Texas gov website, visits are not charged if it’s for an emergency life-threatening situation, prenatal care, chronic care (such as HIV, TB, etc.) or anything required by the doctors or law.

From article, Feb 2015:

Under the previous system, Texas prisoners were charged $3.00 each time they asked to see a health care provider for non-chronic reasons. They are now charged $100 the first time they request such medical services, which covers their health care fees for one year. If a prisoner seeking medical attention has less than $100 in his or her trust fund account, half the balance in the account is taken along with half of all subsequent deposits until the entire $100 is collected.

The problem is that the vast majority of Texas prisoners, while forced to work if medically able, are not paid for their labor and have no income. Most prisoners rely on funds sent by their families, who also tend to be impoverished, and therefore have little money in their trust accounts. Consequently, they may have to choose between buying commissary items – such as toothpaste, soap, shampoo, food or a fan – and obtaining health care.

Texas is the only state with this $100-a-year system, but 42 states still require some sort of payment for medical visits.

In an article from, April 2017:

A $2-5 medical co-pay in prison or jail may not seem expensive on its face. But when we consider the relative cost of these co-pays to incarcerated people “typically earn 14 to 63 cents per hour”

In West Virginia, a single visit to the doctor would cost almost an entire month’s pay for an incarcerated person who makes $6 per month. In Michigan, it would take over a week to earn enough for a single $5 co-pay.

The issue is worse when you consider states that don’t pay inmates for their work. Those states are: Alabama, Arkansas, Florida, Georgia, Mississippi, South Carolina, and Texas. People incarcerated in these states must rely on deposits into their personal accounts – typically from family – to pay medical fees. In most places, funds are automatically withdrawn from these accounts until the balance is paid, creating a debt that can follow them even after release.

“Personal accounts” and “commissary accounts” have been mentioned a few times. So what are those? Prisons don’t allow inmates to have cash. Instead, the facility has an account on record for them, where their wages are deposited. This allows them to make purchases at the commissary store in the facility.

Things sold there are hygiene items like shampoo, conditioner, toothpaste, deodorant… stationery such as pens, paper, stamps… food like ramen noodles, chips, drinks… sometimes clothing items or things like a radio.

The reason commissary funds are so important is that these are items inmates have no way of obtaining except from the store (and through trades, which are technically illegal). Want to write to your lawyer? Gotta buy paper and stamps. Want shampoo? The prison doesn’t provide shampoo. The food in prisons is infamous for basically being bland mush, and the spice packets inside ramen noodles are used as seasoning.

From a forum on from 2008, I found a number of people reporting what their friends/family were provided by the prison itself. There were four different examples.

  • Toothpaste (every other week), toothbrush (every other week), razor (once a week), soap (once a week) and 1 roll of toilet paper (once a week)
  • Razors twice a week, one roll of toilet paper a week, one toothbrush/paste a month, washcloth every 6 months (sometimes), hotel-size soap once a week. Shampoo and deodorant are not provided.
  • One reported in 2005 their state would hand out packets of shampoo, razor, and toothpaste, but have since stopped doing that. The showers have a ‘watered down soap’ dispensed for everything, and if you couldn’t afford a razor, when the prison barber would make a round, they’d shave off your beard.
  • In Florida, one person reported the law requires all inmates to shave and have hair cuts, so they provide razors. They’re given a travel-sized toothpaste tube once a month, and ½ bar of soap once a week. They’re expected to clean their dishes with the same soap.

In 2013, stated about hygiene items, that all prisoners are provided:

two bars of soap each month (often of the hotel-sized variety),
generic toothpaste, a toothbrush (either a flimsy one with a handle or one of the two inch varieties, which must be held with finger and thumb), a few
single-blade razors, and deodorant. 
Often these supplies are distributed on a set day each month.  For example, at FCI Petersburg, hygiene bags,
which contain all of these items (plus paper and envelopes), are passed out on a specific Wednesday morning each month. 
If a prisoner misses this pick-up, they miss out on their hygienic
supplies for the month.

There are two kinds of jobs inmates can have. The first, which we’ll call “regular jobs”, is to help maintain the facility. Jobs like laundry, janitorial work, running the store, groundskeeping, etc. For most of the people I have personally written to, these are the jobs they have, and the competition for them is fierce. You have to maintain “good behavior” to be able to work, and if you slip up or end up at the wrong place at the wrong time (such as a fight breaking out next to you and the guards assume you are involved), you will lose your job. published a report on prisons in the state of Washington in the year 2000, which stated “Almost ¾ of inmate labor, or 73% of all hours reported, offset costs of incarceration in Washington jails.”

The most common jobs held by inmate workers were: laundry service, food service, janitorial work, vehicle washing/detailing, landscaping, inmate uniform repair, barber services, and truck loading/unloading.

The other kind is working for a business, either owned by the state, or a private company contracting with the government, or as part of a work program intended to prepare inmates for release.

That same report stated “Inmate workers provided 729,755 labor hours to a wide variety of government agencies, representing 22% of all hours worked. Most work was done by minimum-security offenders leaving the jail to work off-site, and by offenders performing community service hours in lieu of incarceration.” Categories for these are vehicle washing, grounds maintenance, general labor, litter pickup, fairgrounds maintenance, parks maintenance, and janitorial services.

None of these jobs pay well. According to’s report in 2017, the average wage for regular jobs ranges from 14-63 CENTS PER HOUR, and for jobs in external businesses, the pay is 33 cents to $1.41 an hour.

Besides states that do not pay inmates for their labor at all, the lowest I saw was West Virginia and Louisiana tied at 4 cents an hour. The highest rate of pay was $5 an hour, working in Nevada for a private business.

However, that amount does not include deductions. reports that these fees “often leave incarcerated workers with less than half of their gross pay. In Massachusetts, for example, at least half of each paycheck goes into a savings account to pay for expenses after release.”

Massachusetts pays their inmates 14 cents an hour at the lowest. For those prisoners, they are in fact making 7 cents an hour.

Reports on how many hours inmates work was spotty, but the report on wages used an average of roughly 6.5 hrs worked a day, roughly 5 days a week. So about 32.5 hours worked per week.

Our hypothetical Massachusetts inmate, then, makes $4.55 a week before deductions, and about $2.30 a week after that half deduction.

According to the gov website “Prisoner’s Legal Services of Massachusetts”  it lists the fees charged to prisoners, which include:

  • Medical visits, between $3 to $5 a visit
  • Haircuts. It says “deduct the charge for a haircut from one half of the money the prisoner earns at a prison industries job (except for lifers and sex criminals).” It doesn’t specify half of what amount – is this forever, for one week, or what?
  • A fee for maintaining their prison accounts (remember, the only way they can access their money at all) – $1 activity fee when they receive money from the outside or send money out in a check.
  • Victim and Witness Assessment Fees – According to the Mass Legislature gov website, a witness fee is when any witness states they need to be paid to investigate whatever they’re testifying about. Any witness can request this fee, and it is paid for by the defendant. The prison will take any/all money from the prisoner’s account without their consent at any time to pay this fee.
  • Child Support – the site states “Imprisonment does not stop a prisoner’s legal obligation to pay child support.” They don’t take money from the account without the prisoner’s consent unless the court orders wage garnishment for them similar to how it does to free-world people.
  • Lastly, in 2008 the courts ruled any and all funds can be seized as a disciplinary punishment at any time. The site advises prisoners to keep as little money in their fund as possible because “nothing but a disciplinary hearing stands between the prisoner and loss of whatever assets he or she may have, whether from prison jobs or friends and family.”

In a future episode, we may discuss how disciplinary hearings are not necessarily always fair and just, or the numbers on how many prisoners are abandoned by their family or have no family to begin with.

But imagine our hypothetical Massachusetts prisoner, making 14 cents an hour, half of which is reportedly withheld for use upon release. He makes $2.30 a week, which is not enough to afford a $3 medical visit. He can barely afford to buy a 12 oz bottle of shampoo, which according to Prison Policy’s report on commissary items, cost $1.38 in Massachusetts in May 2018. If he wants to write to his lawyer or any organization willing to protect his rights, he would have to budget for that in his $2.30 a week funds.

If his wages are being garnished for child support, if he wants a haircut, if the court has charged him for any witnesses used in his trial, that needs to come out of his $2.30 a week.

If he does have family or friends outside of the prison, he will have to buy phone cards in order to speak with them. And if he wanted to send money home to support his family, that check would take $1 to process, which is a little less than half of his entire week’s paycheck.

And at any point, if the facility finds him in need of discipline for his behavior, they can take all of those wages away in one sweep.

So when we talk about having a $3-5 medical visit fee, and we talk about how inmates who have stomach ulcers or pneumonia or a staph infection don’t seek out medical care until the point where it’s a medical emergency and they’re dying (which, by the way, emergency medical services – free to them)… this is why they aren’t going to the doctor.

And that’s for prisoners who do have a means of working and earning wages while incarcerated. Going back to the letter I read at the beginning, that prisoner was not paid for their work at all, but is expected to spend $100 on a medical visit. $100 which must be entirely paid for by outside family and friends willing to put money into that person’s account.

One of the reasons stated for WHY prisons charge their inmates for things like shampoo and medical care is that they are trying to offset the high costs of housing these inmates. That was certainly the answer given in 2011 when Texas rolled out this $100/year medical visit policy. Medical costs for Texas inmates are skyrocketing, because so many of their populations are getting older, having had long prison sentences they have no hope of being released from.

So, what do you do when you have a prison full of old men who are starting to get sick? Charge them for being sick! $100 per inmate who needs to see a doctor. Great solution! But… it didn’t work. According to a public records request filed by Prison Legal News, “the Texas Department of Criminal Justice collected $1,552,281.87 in medical copays from state prisoners in 2014 – less than .05% of the department’s annual budget. “

There are talks reported on two different sites that there are negotiations happening behind the scenes to try and post a bill in Texas that will raise the copay to $200/year. Cause, you know, They collected OVER ONE MILLION DOLLARS from the prisoners to pay for their medical care and it didn’t work. So why not try charging even more? Like that Prison Legal News article says, family members will do anything to help their loved one who is sick and dying. Of course they will. $100, $200, they’ll find a way. And since most prisoners are from families deep below the poverty line, their families are likely making minimum wage. In Texas, that means they’re making $7.25 an hour, which comes to about $200 after taxes. So you want a family, potentially a single-parent household since you locked up the other parent, to shell out half of their weekly wages (soon to be an entire weeks’ wages) to get shitty subpar medical care for a loved one YOU, Texas gov, are requiring to work but refusing to pay any wages.

Great fucking job, Texas.

And just a note, these inmates we’re talking about DO INCLUDE immigrants detained by ICE. From an article in the Houston Chronicle, “Texas holds about 1/3 of the nation’s ICE detainees, and at least 25 of the facilities used by ICE are private prisons.”

The company running many of these private prisons is called GEO, “which lists ICE as its number one customer,” according to that Houston article.

The dept of Justice (for the whole country, not just Texas) reported in 2014 they paid $22k per prisoner to private prisons, and a article published in 2016 cites contracts between private prisons and state governments can range from $3k to $18k a year per bed in a facility, whether a prisoner uses it or not. Yeah, $100 isn’t going to put a dent in that. And trying to make prisoners pay for their own incarceration is a whole other level of bullshit.

GEO is, of course, accused of illegally contributing over $225k to Trump’s campaign. And in the first quarter after Trump was elected, their net income rose to $40.4 million, up nearly 25% from the year before.

So, just… an idea… a concept… maybe we should be asking who is profiting off of these high costs of maintaining prisoners, instead of trying to make the impoverished families of inmates shell out money to get the the shitty sub-par medical care Texas facilities offer (which btw, the shittiness of medical care in prison is a topic for a whole other episode).

Like… This is just the first episode, and it’s a struggle for me to touch on every facet of this issue. We haven’t even discussed the fact that 8 cents an hour is absolutely fucking bullshit, especially when the job they’re doing is working as a janitor for a state agency or a private company – a job that normally would make at LEAST that state’s minimum wage.

But there’s always next week, and trust me, there’s plenty more to be mad about.

Sources Referenced:

Music is by Atom James (soundcloud | bandcamp).

Chain art by, courtesy of Freepik.

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