Bowing to pressure from jails and companies, FCC raises phone rate caps

The agency has voted to raise rate caps to accommodate complaints made by companies and facilities, saddling low-income families with higher costs.

by Wanda Bertram, October 30, 2025

This post was updated on November 7, 2025 to include a link to the FCC’s order, and updating the table of rate caps, which changed slightly between the FCC’s proposed order and the final order.

On Tuesday, the Federal Communications Commission voted to increase phone and video calling rate caps for incarcerated people, changing the rules that it adopted last July and then suspended earlier this year. The new rate caps hike prices by as much as 83% compared to the rates announced last year.

The FCC issued rules last year — as required by the Martha Wright-Reed Fair and Just Communications Act — bringing unprecedented relief to families who, all too often, were forced to choose between the cost of communicating with their loved ones behind bars and meeting basic everyday needs. After issuing the rules, the FCC received complaints from phone companies, sheriffs, and state attorneys general. Bowing to this pressure, the agency suspended its 2024 ruling and calculated new rate caps, which inflate the rates and impose new costs on families.

Phone companies and sheriffs challenged the 2024 rules, claiming that they made it unprofitable for companies to serve certain very small jails, as well as to offer call monitoring technology — previously given to jails as a kickback. Neither the companies nor the FCC have ever published any data to back up these claims.¹ Nevertheless, the FCC adjusted its calculations to:

• Incorporate all “safety and security” costs (such as call monitoring and surveillance services) into rate caps;
• Add a 2¢ “facility fee” to all rate caps;
• Create a new tier of “extremely small jails” with fewer than 50 people, where rate caps will be higher.

The FCC also added, at the eleventh hour, a 6.7% “inflation factor,” which increased most of the rates in its proposed order from October by one or two cents per minute.

The final rate caps are much higher than those passed in 2024. However, in a rare piece of good news, the FCC will reinstate two parts of its 2024 ruling: the ban on site commissions (kickbacks that companies give to facilities) and on ancillary fees, both of which had had the effect of inflating the final costs families paid.

Ultimately, these higher rate caps further burden incarcerated people and their families, while lining the pockets of companies and facilities.

Facilities still have a choice

The new rate caps are set to go into effect as soon as the order is published in the Federal Register, although facilities will have 120 days to come into compliance.

It’s worth noting that the rate caps instituted by the FCC represent the legal maximum that prisons and jails can charge for phone service. The new rate caps are higher than what many facilities were charging even before the 2024 rules, and in the few months when those rules were in effect, thousands of facilities across the country implemented them successfully.

It is up to each individual jail and department of corrections to decide whether it will keep these lower rates — which guarantee more family contact and thus reduced recidivism — or choose to raise them, imposing the cost of call monitoring technology and other perks from companies onto families struggling to stay connected.

Almost half of all incarcerated people are in rural jails and prisons and at risk of losing access to hospitals

The Trump administration's One Big Beautiful Bill Act will result in the closure of many rural hospitals, leaving people in the surrounding communities — including those in prisons and jails — facing elevated healthcare costs and limited access to necessary healthcare.

by Emily Widra, October 28, 2025

Nearly a million incarcerated people depend on rural hospitals for routine off-site and emergency medical care.¹ Almost 60% of people in prisons and 25% of those in local jails are confined in rural counties, which are home to 3,000 of the nation’s correctional facilities. Following massive cuts to Medicaid passed by Congress this year, many rural hospitals will be forced to scale back operations or close entirely. As a result, critical, lifesaving healthcare will be further out of reach for huge swaths of the incarcerated population and those who live and work nearby, making an already bad situation far, far worse.

Rural and jail prison population estimates are based on an analysis of Vera’s Incarceration Trends jail data and the Bureau of Justice Statistics’ Census of State and Federal Correctional Facilities, 2019. The percentage of rural hospitals at risk of closure in each state as of August 2025 comes from the Center for Healthcare Quality and Payment Reform’s report, Rural Hospitals At Risk of Closing. See the methodology for more details.

The divisive “One Big Beautiful Bill Act” imposes significant cuts to Medicaid that slash funding for rural hospitals,² which are largely dependent on federal subsidies to stay afloat.³ Closing rural hospitals has disastrous consequences for entire communities, but especially for incarcerated people who have no choice about where they receive medical care. Rural communities can expect limited access to emergency care, higher costs for healthcare, and less-timely and more geographically distant medical treatment. The resulting loss of jobs and healthcare providers risks escalating poverty, unemployment, and disability rates, exacerbating an already dangerous cycle that often leads to incarceration.

Policy TrackerHow Trump is making the criminal legal system worse

In this briefing, we present our estimates of the number of people in prisons and jails who are locked up in rural counties and explain how rural hospital closures would spike healthcare and incarceration costs while worsening public health. We are also making these state-by-state estimates available in an appendix. Additionally, we examine how a weakened rural hospital system can make healthcare delivery even worse than it already is for people on the inside. Finally, we highlight ways in which the consequences of rural hospital closures — unemployment, inadequate healthcare access, poverty — are felt across entire rural communities, not just behind bars.

The incarcerated population is disproportionately sick, aging, and locked up in rural areas

With more than half of prisons and around a quarter of local jails situated in rural counties, rural hospital closures pose real risks to incarcerated people’s health and wellbeing.⁴ Incarceration has a negative impact on the health of people behind bars and shortens life expectancies — a state of affairs that is especially worrisome given the increasingly elderly and sick incarcerated population.⁵ Researchers warn that closing rural hospitals “can increase the risk of bad outcomes for conditions requiring urgent care, including that for high-risk deliveries, trauma, and heart conditions.” These bad outcomes are particularly likely among the incarcerated population, where some of these conditions are common: for example, about 2% of women entering jail are pregnant and many jail births are high risk. Additionally, heart conditions are the second leading cause of death in prisons and jails. Many correctional facilities already struggle to provide basic healthcare to incarcerated people and have disturbingly high mortality rates. These issues will inevitably worsen with the loss of important medical infrastructure nearby.

The impact on state prison systems

In almost every state, thousands of people in prison who need emergency and routine off-site medical care (such as imaging and x-rays, surgeries, and specialist care) rely on nearby rural healthcare systems that are now threatened by Medicaid cuts. This is particularly alarming in states that almost exclusively hold incarcerated people in rural areas, like Idaho, where 91% of people in prison are in rural counties.⁶ But the scale of the problem is worse in states with some of the largest prison systems — like Texas, Florida, California, Georgia, Pennsylvania, Arizona, and New York — where between 30,000 and 117,000 people in rural prisons rely on those hospitals in each state. Nationally, more than 783,000 people are in prisons in rural counties.⁷

People in prison already have to contend with delayed referrals to medical specialists, which (along with understaffing) contribute to higher mortality (death) rates on the inside. The carceral system is notorious for denying and slow-walking medical care, and for the convoluted, lengthy process required to be seen by a healthcare provider — practices that undoubtedly contribute to higher mortality rates on the inside.⁸ In rural facilities, these conditions are often exceptionally bad.

Prisons vs. jails Learn more about the difference.

In Louisiana — where 42% of the state prison population is incarcerated in rural counties — the prison mortality rate is more than double the national rate in state prisons, according to the most recent national data. From 2001-2019, Louisiana had the highest prison mortality rate overall, as well as for deaths related to heart disease, cancer, AIDS-related illnesses, and respiratory disease. Such severe healthcare needs require ready access to emergency and specialist care at a nearby hospital, and yet the Center for Healthcare Quality and Payment Reform estimates that 46% of Louisiana’s rural hospitals are at risk of closure, with at least nine at immediate risk of closure due to federal funding cuts.

Impact on local jails

Nationally, almost 170,000 people are incarcerated in rural jails. In 19 states, more than one-third of the statewide jail population is confined in rural counties. Six of those states confine more than half of their entire jail population in rural counties.⁹ Even in states with large rural populations overall, the share of the jail population in rural counties still stands out: for example, in Mississippi, where about half of the statewide population lives in rural areas, almost 70% of people in jail are held in rural counties. In Kentucky, where around 40% of the state lives outside of metropolitan areas, a disproportionate 67% of the statewide jail population is confined in rural jails.

Each year, more than five million people are arrested and booked into jail and they are more likely to have serious health needs — including mental illness, substance use disorders, HIV, Hepatitis B or C, cirrhosis, and heart conditions — than people who are not jailed. Troublingly, small, predominantly rural jails consistently report the highest jail mortality (death) rates in the country.¹⁰

The medical care that people receive inside jails is terrible in most places, but it is particularly bad in states with mostly rural jails and prisons. These facilities compete with community healthcare systems for limited resources, including qualified staff, and their failure to provide adequate medical care on the inside puts additional strain on local hospitals. When patients arrive from the jail or prison, their care has often already been delayed, making their health issues more severe and likely to require emergency or specialized treatment.

For example, in Virginia, where about 40% of the state’s prison and jail facilities are in rural areas, there have been at least three civil rights cases related to healthcare in prisons and jails since 2010. In U.S. vs. Piedmont Regional Jail Authority (2013), the U.S. Department of Justice alleged that the rural regional jail in Prince Edward County was permitting unqualified staff to evaluate medical conditions, inadequately screening for medical issues on admission, and providing subpar mental healthcare. The lawsuit resulted in the appointment of a court monitor to oversee the jail’s efforts to address these issues, but subsequent jail deaths suggest problems persisted. Similarly, in West Virginia — where 53% of the jail population is in rural counties — formerly incarcerated people already report serious healthcare issues on the inside, including delays in cancer screenings, lack of access to insulin, and abrupt discontinuation of prescription medication. Accordingly, West Virginia also had the second highest jail mortality rate in the nation at last count in 2019.

Rural hospital closures are associated with rising healthcare and incarceration costs, and worse public health outcomes

In the past decade, more than 100 rural hospitals have closed and more are at risk: the Center for Healthcare Quality and Payment Reform reports that in most states, over 25% of rural hospitals are at risk of closing, and in 10 states, at least half are at risk as of August 2025. Aside from providing crucial emergency care, inpatient medical care, and laboratory testing and diagnostics, rural hospitals are often where the community receives routine primary care and inpatient rehabilitation services. These closures can “wreak irreparable havoc on rural communities” and will, in turn, make it harder to reverse local population declines, threatening to turn these communities into “ghost towns.”

Beyond the community-wide effects of hospital closures – including unemployment (including in non-healthcare industries), lower income levels, and slower economic growth – the tendency of police to target poor and chronically ill populations means that people who fall through the cracks as a result of these cuts to crucial federal subsidies risk being swept into the system. With evidence that high county jail incarceration rates are associated with a rise in county-wide deaths, Medicaid cuts risk accelerating a dangerous cycle of poverty, illness, incarceration, and death in rural communities.

Medicaid cuts also stand to make already-costly medical care for incarcerated people far more expensive by placing services further out of reach. People living in rural areas live an average of 10.5 miles from the nearest hospital (roughly twice the distance in other areas), and over one-third of rural hospitals that closed between 2013 and 2017 were more than 20 miles from the nearest hospital. States, counties, and municipalities are ultimately on the hook for the high and steadily rising costs associated with medical care for incarcerated people. In Cheshire County, New Hampshire, for example, the county jail already budgets $50,000 for healthcare outside of the facility, which is expected to cover medical care for 100 people in jail, including one person who requires dialysis to the tune of $6,000 every month. In Virginia, 27% of the prison healthcare budget in 2015 was spent on off-site hospital care.

In particular, the costs of transporting incarcerated people to hospitals for off-site or emergency care are already extreme. In Michigan, the cost for 224 ambulance trips to the rural Chippewa County Correctional Facility is upwards of $430,000.¹¹ Meanwhile, in New Hampshire, Department of Corrections expenditures on ambulances rose by 176% from 2022 to 2023. Requiring transport to hospitals that are further away will cause these costs to climb even higher, and will incentivize corrections departments to avoid doing so as much as possible.¹² Prisons and jails already engage in this practice because of untenably high transport and staffing expenses.¹³ In Allegheny County, Pennsylvania, (which is not even a rural county), medical transport from the jail “takes two correctional officers out of the jail for up to 10 hours.” In a survey of jail staff in southeastern states, one jail employee reported that they “try and get rid of dialysis patients as quickly as [they] can, too, because they don’t wanna have to transport them three days a week to dialysis.” In addition to delaying offsite transportation as much as possible, corrections authorities may also try to deflect rising costs onto their (typically poor) incarcerated patients. As the National Consumer Law Center notes, jails in at least 25 states already engage in such practices:

“When an incarcerated person suffers from an acute medical issue that requires care that the jail cannot provide in-house, some sheriffs will release the person on “medical bond” before transporting them to a hospital so that the jail will not have to pay the medical bills. Once the person receives treatment and recovers, the sheriffs then often quickly move to rearrest and book the person back into jail.”

The failure to address people’s health needs while incarcerated exerts pressure on the remaining healthcare infrastructure as sick people leave correctional facilities and return home. For example, people on probation and parole face higher rates of substance use disorders, mental health diagnoses, chronic conditions, and disabilities than the general population, and over a quarter of people on community supervision have no health insurance, further limiting their access to adequate healthcare in the community.

Conclusion

The latest cuts to Medicaid pose substantial risks to both rural communities and the people who are incarcerated within them. Healthcare for incarcerated people is already abysmal, and jails and prison systems have been complaining about the rising medical costs for years. Medicaid cuts will pour fuel on this fire by forcing many rural hospitals to close. Further restricting timely access to routine off-site and emergency medical care will stoke worse health outcomes and higher mortality rates for an aging confined population. Given that most incarcerated people will eventually return to the community, these problems will exacerbate larger public health issues, impact community-wide mortality, and further burden the existing, limited emergency medical services in rural communities. Taken together, these factors paint a grim picture of the future for all people in rural communities as the combination of poor health and poverty makes rural communities more of a target for policing and incarceration. The destruction of rural public health infrastructure is a policy choice that inevitably favors using jails and prisons to manage increasingly poor, sick, and neglected populations through punishment rather than care.

Highlights from a busy year at Prison Policy Initiative

In our new annual report, we share examples of how we are building on the foundations of our research and visualizations to meet the challenges of this moment

by Danielle Squillante, October 23, 2025

We wrapped up another productive year at the Prison Policy Initiative, and are thrilled to share our 2024-2025 Annual Report with you. We released 5 major reports, 24 research briefings, 2 new resources as part of our Advocacy Toolkit, and several briefings related to our campaign to end prison gerrymandering. We also provided technical support to advocates at the state and local levels working on issues such as fighting jail expansion, making prison visitation a right, and water contamination in prisons.

Here are a handful of accomplishments we’re particularly proud of:

• We published an update to our flagship Mass Incarceration: The Whole Pie report detailing the scale of mass incarceration in the U.S.
• We released reports tackling two of the most consequential issues for incarcerated people — prison disciplinary systems and prison health care. Using a combination of deep analysis and first-hand accounts of these systems, we peeled back the curtain to show how these systems traumatize incarcerated people both physically and mentally.
• As part of our campaign to end prison gerrymandering, we produced 5 reports that highlight the scale and impact of prison gerrymandering in Oklahoma, North Carolina, Louisiana, West Virginia, and Kansas.
• Through our partnership with the Jail Data Initiative, we published 3 briefings utilizing present-day data from roughly 900 jails to provide a better understanding of those who are criminalized and locked up. Our briefings focused on the criminalization of unhoused people, the demographics of people booked into jails multiple times, and offense data for people in local jails.
• We expanded our focus on federal criminal legal system policy and launched our new federal tracker that connects the dots of the Trump administration’s actions to show its larger strategy of doubling down on the failed policies that created the nation’s mass incarceration crisis in the first place.
• Our Policy & Advocacy team hosted 3 webinars on organizing legislative testimony from incarcerated people, pushing back against unproductive and inaccurate uses of recidivism stories and statistics, and fighting back against jail expansion.

This is only a snapshot of what we produced this past year. We are proud of our accomplishments and look forward to sharing new projects with you in the year to come.

How to get started reporting on issues with parole release in your state

We explain how to use our 35-state report Parole in Perspective to jumpstart investigations into your state's parole system.

by Wanda Bertram, October 20, 2025

Frustratingly little data exists about discretionary parole systems in the U.S. — a gap that hinders policymakers, incarcerated people, advocates, and journalists attempting to navigate the system, assess its effectiveness, and champion meaningful reforms.

To fill the gap, the Prison Policy Initiative released a new report, Parole in Perspective, designed to pull back the curtain on how discretionary parole works in 35 states (the states that still use it to release people serving a wide range of sentences). Part one of this report explores the makeup of parole boards and how they conduct hearings. Part two dives into the data on parole hearings and grant rates in these states, and the criteria that boards use in determining whether someone will be released.

If you are a journalist reporting on parole, our report can help — whether you’re just looking for an introduction to these systems or trying to investigate them in depth.

Parole in Perspective answers basic questions like:

• Which states still have discretionary parole?
• Who is making parole decisions in your state?
• How many people are granted parole in your state every year? How has this changed over time?
• How much data does your state publish about parole release, compared to other states?

Our report can also serve as a starting point for answering more complicated questions about parole, such as:

• How are parole boards making decisions? Our appendix table breaks down which criteria boards are required to take into account in each state. For instance, some boards are required to consider a person’s age — a relevant factor as prison populations get older and as a growing number of states recognize youth under 25 as less culpable for their actions. Importantly, most boards place a lot of weight on factors that the applicant has no control over, such as the original crime for which they are locked up.
• Are punitive sentencing reforms forcing people to wait longer for parole hearings? While our report does not discuss such reforms directly, we show that in almost every state, parole boards are holding significantly fewer hearings today than they did several years ago — suggesting that various factors, including “Truth in Sentencing”-style reforms, are having an impact.
• How much time is the board likely spending on each individual case? Our report shows how many people have parole hearings in an average year, by state; as well as how many members each state’s parole board has. States vary widely in the size of their parole boards and how many members are required to hold a hearing.
• Is the availability of housing and programs shaping parole grants? For example, our report shows which parole boards take someone’s reentry plan into account, which depends on housing and other services. The availability of in-prison programming also influences grant rates in states that consider someone’s accomplishments behind bars.
• How is the format of parole hearings affecting decisions? As we explain in the report, a growing number of states are transitioning to virtual hearings — and a handful do not allow applicants to be present at their hearing at all.

Questions about discretionary parole can come up on a wide range of stories: It is a key aspect of timely issues such as the aging prison population and the “tough-on-crime” creep among elected officials. We hope this report serves as a useful tool for reporters seeking to shine much-needed light on these systems. And for any questions about parole systems that the report does not answer, we’re here to help. Reporters can reach out to us through our contact page for quick assistance exploring these and other issues.

New report, Parole in Perspective, shines a light on how parole boards work and how parole decisions are made in 35 states

Despite their differences, all discretionary parole systems have serious design flaws and most are steadily releasing fewer people, a new report shows.

October 7, 2025

A new report from the Prison Policy Initiative pulls back the curtain on parole release systems, providing the most accessible and comprehensive source to date for comparing how these essential — and often dysfunctional — release mechanisms are set up in 35 states. The report, Parole in Perspective, reveals that parole releases are on the decline in nearly every state that uses discretionary parole, highlighting elements of the process that contribute to this urgent problem.

Parole in Perspective comprises two parts, each honing in on different elements of parole release. The first explores the makeup of boards and how they conduct hearings. The second dives into new data on hearings and grants, and the factors that boards consider — including their discretion — in determining whether someone will be released.

The report contains four essential data tables showing:

• How parole boards in 35 states are composed and how they hold hearings;
• The number of parole hearings and grants in every state from 2019-2024;
• How parole boards compare on the criteria they use to determine release;
• The exact statutory text guiding parole boards’ decisionmaking in every state.

Parole in Perspective coincides with the Prison Policy Initiative and MacArthur Justice Center’s release of their Principles for Parole Reform, a guiding “North Star” document designed to help activists and policymakers identify priorities for reform in their states.

Both the new report and the Principles for Parole Reform identify crucial flaws in parole systems today, including:

• Relying too heavily on factors outside of applicants’ control — such as “the severity of the offense” or a perception that release would “diminish the seriousness of the crime”;
• Making irrational parole decisions in favor of keeping applicants locked up, often flying in the face of what risk assessment tools recommend;
• Stacking boards with law enforcement professionals, while ignoring the perspective of people with experiences of incarceration;
• Increasingly holding virtual rather than face-to-face hearings, or worse, not affording parole applicants a hearing at all.

“Despite their differences, all discretionary parole systems have serious design flaws that lead to an unfair preparation and hearing process for incarcerated people,” said report author Leah Wang. “By shining a light on boards and their practices, we hope to lay a path toward making these systems real tools for decarceration.”

The full report is available at https://www.prisonpolicy.org/reports/parole.html.