Five national associations have signed on to bi-partisan legislation seeking to amend components of the federal Medicaid Inmate Exclusion Policy (MIEP) for incarcerated individuals. Changes would allow coverage for eligible detainees 30 days prior to release and for those yet to be convicted of a crime. 

Recently the National Association of Counties (NACo) was joined by state and local government partners in sending a letter to leaders on the US House of Representatives Energy and Commerce Committee, urging support for bipartisan legislation to reform the Medicaid Inmate Exclusion Policy (MIEP). The proposed revisions would strengthen continuity of care, improve health outcomes, and reduce recidivism among justice-involved individuals. The NACo website has published a breakdown of the two-bill package.

As previously covered on Conduit Street, the MIEP disqualifies individuals from federal health benefits when they are admitted to a detention center and this includes those who have yet to be convicted of a crime. The result is a denial of federal benefits to pre-trial detainees and any members of their family that are covered, regardless of their constitutional right to presumed innocence under the law. Adversely, people who can afford to bail out keep their coverage.

In local detention centers the cost for services falls on county governments where the full expense is shifted to the local tax payer in order to fund hospital and healthcare treatments. For scale, 90 percent of the nation’s local detention centers are operated by county governments and those facilities hold a population 18 times that of the federal and state prisons combined, according to a NACo report. Another study by NACo holds company with other research across the country showing that serious mental illnesses and substance use disorders are three to four times more common among local detainees than the general population.