Maryland's prison agency is enrolling in Medicaid fewer than a tenth of those who leave prisons and jails every year, according to state data. Few other states that have expanded Medicaid under the health law are doing any better, specialists say. Officials of the Maryland Department of Public Safety and Correctional Services say they enroll the most severely ill in Medicaid while letting most ex-inmates fend for themselves. Some 12,000 of Maryland's 21,000 prison inmates are designated at any given time as chronically ill, according to prison officials. Given limited means and the already tall order of connecting emerging prisoners with transportation, shelter and employment, the system must focus on enrolling the very sickest, according to the prison medical director. From Jan. 2014, when Medicaid expansion took effect, through March of this year, Maryland released almost 16,000 people sentenced to prison or jail, according to state data, but the corrections department said it enrolled only 1,337 released inmates in Medicaid from the beginning of 2014 through late March. Another 1,158 prisoners joined Medicaid over that time when they were hospitalized. Many ex-prisoners are enrolled only when they experience a crisis and end up in an ER.