The County Countdown – August 7, 2023
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Key Takeaways
Every other week, NACo’s County Countdown reviews top federal policy advocacy items with an eye towards counties and the intergovernmental partnership.
Members of Congress are away from D.C. for August recess. This is an ideal time for counties to engage with federal representatives by showcasing key projects and operations. Before jumping into our countdown, consider how you might use this recess period to strengthen intergovernmental relationships.
Watch the above video and explore NACo resources below on some of the top issues our members tackled at this year’s conference.
1. American County Platform
Revisions to the American County Platform were approved at NACo's Annual Conference last month.
- Through the collective effort of over 700 steering committee members, along with our Board of Directors, NACo's membership ratified more than 140 resolutions and platform changes.
- What’s next? This document will guide our advocacy efforts throughout the coming year.
2. Mental Health & MIEP
The Medicaid Inmate Exclusion Policy (MIEP) strips federal health benefits from individuals admitted to jail before they are convicted of a crime, violating their constitutional rights and presumption of innocence.
This policy strains local judicial, law enforcement, public safety, and human services systems, contributing to higher recidivism rates and poorer health outcomes.
We urge counties to contact Congress in support of two bipartisan bills:
- The Reentry Act: Facilitates Medicaid payments for services prior to an individual's release.
- The Due Process Continuity of Care Act: Allows pre-trial detainees access to Medicaid benefits if their state chooses.
3. PFAS
Per- and polyfluoroalkyl substances (PFAS) compounds, often referred to as “forever chemicals,” pose significant health and environmental threats, including the potential contamination of drinking water.
- Regulatory action: The Environmental Protection Agency (EPA) is now stepping in with regulatory actions addressing PFAS.
- The county role: Given our multifaceted role as owners, users and regulators of water resources, county governments stand at the forefront of combating PFAS exposure.
4. Mental Health Parity
As key intergovernmental partners, county representatives attended a recent White House announcement on mental health parity.
- The news: A proposed rule seeks to implement the existing Mental Health Parity and Addiction Equity law, originally passed in 2008.
- Echoing NACo's advocacy focus, this proposal is set to enhance intergovernmental relations while catering to the growing demand for mental health solutions.
STAY TUNED!
The County Countdown will be taking a short hiatus during the August recess.
Related News

U.S. House reintroduces legislation to address the Medicaid Inmate Exclusion Policy with NACo support
Two bipartisan bills aimed at addressing the Medicaid Inmate Exclusion Policy (MIEP) were recently reintroduced in the U.S. House of Representatives.

U.S. House of Representatives re-establishes Bipartisan Mental Health Caucus with NACo support
On May 7, members of the U.S. House of Representatives appointed new leadership to the Bipartisan Mental Health Caucus, reaffirming their commitment to addressing the nation’s mental health crisis through cross-party collaboration. This renewed focus is a welcome development for counties, which serve on the frontlines of the behavioral health system. Bipartisan initiatives like this help elevate mental health as a national priority, support counties in advancing meaningful policy change and strengthen partnerships across all levels of government.

House passes SUPPORT Act reauthorization
On June 4, the U.S. House of Representatives passed the SUPPORT for Patients and Communities Reauthorization Act of 2025 (H.R. 2483) by a strong bipartisan vote of 366–57. The bill, which reauthorizes billions of dollars for critical programs that target overdose prevention, now heads to the Senate Committee on Health, Education, Labor and Pensions, where a version of the bill was overwhelmingly advanced with bipartisan support in the 118th Congress.