Counties in states that have expanded Medicaid under the Patient Protection and Affordable Care Act have the opportunity to enroll newly eligible detainees or inmates into Medicaid coverage, which can reduce recidivism and lower county health care costs. One county that has embraced this opportunity is Cook County, Ill. In October 2012, Cook County received permission from the federal government to start early enrollment of newly eligible individuals into Medicaid—and in April of 2013 began the Jail Enrollment Project for newly eligible detainees and inmates at the Cook County Jail. Leaders from the County Board, Sheriff’s Office and Health and Hospitals System came together to develop a plan to enroll individuals in the jail and connect them with health coverage and services. In this episode, we hear from several of those leaders – Cook County Board President Toni Preckwinkle, Cook County Sheriff Tom Dart, and CEO of the Cook County Health & Hospitals System, Dr. John Jay Shannon – about why jail enrollment is so important to each of their systems.