Hepatitis C (HCV) in prisons is a public health crisis tied to current drug policy's emphasis on the mass incarceration of drug users. Prison policy acts as a barrier to HCV care by limiting medical care for the infected, especially drug users, and by inhibiting public health measures addressing the epidemic. This Comment argues that courts mistakenly limit prisoners’ Eighth Amendment right to basic medical care when they defer to prisons that apply HCV policies as categorical rules of treatment. Where current standards of care mandate individualized patient evaluation for treatment, prison policies that eschew this principle exhibit deliberate indifference to prisoners’ medical needs. Additionally, this Comment looks beyond deliberate indifference to contemporary standards of adequate medical care and prisoner reentry, proposing (1) that evolving standards of decency require greater care than existing Eighth Amendment standards articulated by the U.S. Supreme Court, and (2) that prisoner reentry policy holds the potential for a shift toward public health reform of prisons. Ultimately, this Comment argues that HCV in prisons implicates a set of critical challenges calling for a fundamental rethinking of the prison as a medical provider, a public health institution, and a part of the community.