Under current law, benefits offered through Medicaid, Medicare, CHIP, and Veterans Affairs do not cover health care services for individuals incarcerated while awaiting trial, despite never having been convicted of a crime
Washington (October 14, 2021) – Senators Edward J. Markey (D-Mass.), Jeff Merkley (D-Ore.), and Sherrod Brown (D-Ohio) today announced the introduction of the Equity in Pre-Trial Health Coverage Act, legislation that would protect the continuity of federal health benefits under Medicaid, Medicare, CHIP, and Veterans Affairs for pretrial detainees, ensuring health care services are provided to an individual who is in custody pending disposition of charges. Currently, individuals who have been arrested and are able to post bail maintain their coverage, while those who remain in custody can lose it despite not having been convicted of the crime for which they have been charged. This policy leads to a gap in coverage for individuals covered by federal health programs awaiting trial. This unfair and discriminatory practice keeps individuals from accessing necessary care in their community, and shifts the cost of medical treatment for pretrial detainees to local city, county, and state agencies, and is particularly concerning for individuals with substance use disorders and other mental health conditions that require consistent and sustained medical treatment. These unnecessary disruptions in care only exacerbate existing health issues for some of our most vulnerable populations and put pressure on local budgets to provide uncompensated care.
“Being unable to afford bail should not be a pre-existing condition for accessing health care. In order to reduce the rate of deadly opioid overdoses in this country, we need a seismic shift in how we provide health care to individuals involved in the criminal justice system,” said Senator Markey. “It is past time to end this discriminatory practice that not only exacerbates existing health issues like opioid dependence and mental health disorders among underserved and underinsured populations, but also strains local budgets. I am grateful to have worked with counties across Massachusetts to call attention to this discriminatory policy, and I appreciate my Senate colleagues for joining me in working to right this injustice.”
“Americans­ who have serious health conditions — including those who are awaiting trial — need access to quality healthcare and can’t afford to be disqualified from those benefits,” said Senator Merkley. “In America, you are innocent until proven guilty, and I am proud to help introduce the Equity in Pre-Trial Health Coverage Act to correct this injustice and ensure that pre-trial detainees can keep their health coverage and seek the medical treatment they need.”
“In this country you’re considered innocent until proven guilty, and taking health insurance coverage away from individuals while they wait for their constitutionally protected day in court is counter to that American value,” said Senator Brown.
A copy of the bill can be found HERE.
The Equity in Pre-Trial Health Coverage Act has been endorsed by the Major County Sheriffs of America (MCSA), the National Sheriffs Association (NSA), the National Association of Counties (NACo), and the Center for Law and Social Policy (CLASP).
“We applaud this important legislation as a critical step in addressing the health inequities and disparities for all justice-involved individuals to improve health outcomes and gaps in care created by the MIEP.” said National Sherriff’s Association Executive Director and CEO Jonathan F. Thompson.
“Individuals involved in the justice system often have unique health care needs and face significant health challenges. Stripping or suspending federal health care benefits for pre-trial detainees, who are presumed innocent, disrupts the care continuum and leads to poorer outcomes and higher rates of recidivism,” said National Association of Counties Executive Director Matthew Chase. “We need a strong federal-state-local partnership to produce the best results for individuals, families and communities. We thank Senators Markey and Merkley for introducing this important bill, and we will work with lawmakers in both parties to secure its passage.” 
“The Major County Sheriffs of America (MCSA) thanks Senator Markey for his continued leadership to improve health outcomes for justice-involved individuals.  Ensuring that individuals maintain access to critical health benefits in pretrial settings will improve care, reduce recidivism, and bolster state and local partnership in delivering safety-net benefits.  MCSA stands ready to support Senator Markey’s efforts to pass the Equity in Pretrial Health Coverage Act,” said Sheriff Koutoujian, President, MCSA.
“It is critical that those impacted by our nation’s criminal legal system are able to get the health care they need, regardless of their ability to pay. The Equity in Pretrial Health Coverage Act is an important step in ensuring people do not lose public health care while they are in pretrial custody. The Center for Law and Social Policy (CLASP) supports this effort and others to eliminate gaps in coverage for those impacted by the criminal legal system as we work to advance racial equity and health justice,” said Olivia Golden, CLASP Executive Director.