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Livingston County joins others raising concerns about Medicaid Inmate Exclusion Policy

Livingston County is joining forces with other municipalities from across the state and nation in voicing concerns related to the Medicaid Inmate Exclusion Policy – a bipartisan behavioral health legislative package.

Outlined under Section 1905(a)(A) of the Social Security Act, the MIEP makes no distinction between individuals housed in jails versus prisons and unfairly denies or revokes federal health benefits for adults and juveniles that are being housed in local jails prior to conviction. The individuals, who are pending disposition, are still presumed innocent under the United States Constitution.


“My hope is that this very important bipartisan healthcare package can be amended for the benefit of both the detained and the local taxpayer,” added Livingston County Sheriff, Thomas J. Dougherty.

The MIEP causes disruptions in primary and behavioral health care access for justice-involved populations that are enrolled in federal programs such as Medicaid, Medicare or the Children’s Health Insurance Plan (CHIP). Not only does this discontinuity in care contribute to detrimental health outcomes for both individuals and their communities, but it also increases rates of jail recidivism. By contrast, uninterrupted health care helps those who enter the criminal justice system break the cycle of recidivism exacerbated by untreated physical and mental illnesses and substance use disorders.


Across our nation, approximately 11 million people cycle in and out of local jails each year, 60 percent of which are pre-trial detainees. The number of individuals being detained pre-adjudication has grown tremendously in the past several decades and paralleled the number of individuals in local jails that are experiencing mental illness and serious mental illness, often with co-occurring substance use disorders.
As a result of this legislative package, Livingston County is responsible for covering the costs associated with healthcare services for individuals who are awaiting trial, therefore creating a financial burden on the County and local taxpayers.

“For our taxpayers to shoulder the brunt of these costs is unacceptable,” added David LeFeber, Chairman of the Board of Supervisors for Livingston County. “We implore Congress to improve this legislation and allow individuals in need of care to receive federal benefits such as Medicaid, Medicare and CHIPS while eligible in our local jails.”

The National Association of Counties estimates that over three billion dollars would be saved each year if pre-trial inmates were eligible to receive federally funded healthcare.



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