Medicaid Inmate Exclusion Policy (MIEP) Advocacy Toolkit

-
Reports & ToolkitsThe Medicaid Inmate Exclusion Policy (MIEP), which denies or revokes federal health and other benefits, is a violation of the equal protection and due process clauses of the Fifth and 14th Amendments of the U.S. Constitution, respectively. This policy also places undue financial and administrative burdens on local jails and produces unfavorable health outcomes for individuals and communities. By contrast, the uninterrupted provision of health care helps our residents break the cycle of recidivism exacerbated by untreated physical and mental illnesses and substance use disorders.Medicaid Inmate Exclusion Policy (MIEP) Advocacy Toolkit
-
Document
Medicaid Inmate Exclusion Policy (MIEP) Advocacy Toolkit
Across America, the double standard created by the Medicaid Inmate Exclusion Policy (MIEP) is putting undue strain on our local judicial, law enforcement, public safety and human services systems. This error in legislation and federal policy results in higher rates of recidivism, increased healthcare costs and poorer health outcomes for residents. This policy drives the over-incarceration of those suffering from mental health and substance use disorders, as county jails have become the largest behavioral health facilities in the nation.
Below, find resources designed to help county officials educate Congress, the administration and the public on the importance of providing access to federal health benefits for those awaiting trial and verdict decisions.
WRITE YOUR MEMBER OF CONGRESS
Download NACo's letter template and send a letter to Congress written on county letterhead, either through the U.S. Postal Service or via email, that explains why it is critical to your county that Congress amends the Medicaid Inmate Exclusion Policy. Information on office locations and contact numbers can be found on members’ websites. Links to U.S. House of Representatives and U.S. Senate websites can be found below.
- Sample Letter
- Contact your Representatives
- Contact your Senators
PUBLISH A LETTER TO THE EDITOR
Connect with your local media outlets to highlight the importance of Congress to amend the MIEP and the negative health and economic impact it has on counties. Write and submit op-ed columns, letters to the editor or guest commentaries to local newspapers outlining the importance of amending MIEP to your county and urging Congress to take action. Below are issue-specific talking points to consider. Remember, your ability to craft and tailor the message to fit your community is very important to publishing an op-ed. County-specific examples and other local information will significantly enhance your advocacy. NACo’s Media Relations Guide for Counties is also available to assist county officials with local media outreach.
- Op-Ed Template
- Talking Points
ENGAGE YOUR MEMBERS OF CONGRESS ON SOCIAL MEDIA
Demonstrate how counties are providing important health care services to justice involved individuals through pictures and stories to encourage Congress to amend the #MIEP. Most Senators and Representatives are on Twitter and monitor their Twitter feeds regularly. The easiest way to find your members of Congress is to utilize the search function on Twitter or by visiting your members’ website. In addition to reaching out to your members of Congress on Twitter, consider targeting House and Senate leadership. You can keep NACo in the loop on your social media advocacy by being sure to include both @NACoTweets and #MIEP in your tweets.
Sample Tweets
11 million individuals cycle through 3,100 local jails each year and many lose access to federal health benefits while they still await trial due to the #MIEP
In #county jails across the country, #MIEP unfairly revokes pre-trial detainees’ federal health benefits such as Medicaid, Medicare, and the Children’s Health Insurance program
#Counties operate 2,875 of our nation’s local jails and the federal government forces counties into undue financial and administrative burdens to cover the cost of pre-trial detainees’ loss of federal health benefits under #MIEP
60% of the 11 million individuals that cycle through local jails each year are pre-trial detainees that unfairly lose access to federal health benefits due to #MIEP
The #MIEP causes disruptions in primary and behavioral health care access for justice-involved populations enrolled in federal health programs. This discontinuity in care contributes to detrimental health outcomes and increases rates of jail recidivism.
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. Congress must #AmendtheMIEP
Termination of health care coverage under #MIEP results in poorer health outcomes, increased recidivism and higher taxpayer costs to #counties
Congress must amend Section 1905(a)(A) of the Social Security Act to allow for the continuation of federal health benefits for pre-trial detainees #MIEP
Innocent until proven guilty. Having access to federal health benefits while awaiting trial with presumed innocence is an individual’s constitutional right #AmendtheMIEP
Congress can help #counties break the cycle of recidivism caused by untreated mental illness and substance use disorders by amending the #MIEP to allow access to federal health benefits for those awaiting trial
Additional MIEP Resources
Learn More about the MIEP
- NACo MIEP Concept Paper
- NACo-NSA Taskforce Report
- Medicaid and Jails
- MIEP Call to Action: Advancing Legislation that Addresses the Medicaid Inmate Exclusion Policy
Estimated Cost of Health Care in Local Jails
- Snapshot: Estimated Health Care Expenditures in Local Jails
Learn More About the Medicaid Program
- Medicaid 101
Veterans in Our Local Justice System
- Snapshot: Health Care Access Issues for Veterans in Our Local Justice Systems
The Medicaid Inmate Exclusion Policy (MIEP), which denies or revokes federal health and other benefits, is a violation of the equal protection and due process clauses of the Fifth and 14th Amendments of the U.S. Constitution, respectively. This policy also places undue financial and administrative burdens on local jails and produces unfavorable health outcomes for individuals and communities. By contrast, the uninterrupted provision of health care helps our residents break the cycle of recidivism exacerbated by untreated physical and mental illnesses and substance use disorders.2023-07-13Reports & Toolkits2023-08-01
Across America, the double standard created by the Medicaid Inmate Exclusion Policy (MIEP) is putting undue strain on our local judicial, law enforcement, public safety and human services systems. This error in legislation and federal policy results in higher rates of recidivism, increased healthcare costs and poorer health outcomes for residents. This policy drives the over-incarceration of those suffering from mental health and substance use disorders, as county jails have become the largest behavioral health facilities in the nation.
Below, find resources designed to help county officials educate Congress, the administration and the public on the importance of providing access to federal health benefits for those awaiting trial and verdict decisions.
WRITE YOUR MEMBER OF CONGRESSDownload NACo's letter template and send a letter to Congress written on county letterhead, either through the U.S. Postal Service or via email, that explains why it is critical to your county that Congress amends the Medicaid Inmate Exclusion Policy. Information on office locations and contact numbers can be found on members’ websites. Links to U.S. House of Representatives and U.S. Senate websites can be found below. |
PUBLISH A LETTER TO THE EDITORConnect with your local media outlets to highlight the importance of Congress to amend the MIEP and the negative health and economic impact it has on counties. Write and submit op-ed columns, letters to the editor or guest commentaries to local newspapers outlining the importance of amending MIEP to your county and urging Congress to take action. Below are issue-specific talking points to consider. Remember, your ability to craft and tailor the message to fit your community is very important to publishing an op-ed. County-specific examples and other local information will significantly enhance your advocacy. NACo’s Media Relations Guide for Counties is also available to assist county officials with local media outreach. |
ENGAGE YOUR MEMBERS OF CONGRESS ON SOCIAL MEDIADemonstrate how counties are providing important health care services to justice involved individuals through pictures and stories to encourage Congress to amend the #MIEP. Most Senators and Representatives are on Twitter and monitor their Twitter feeds regularly. The easiest way to find your members of Congress is to utilize the search function on Twitter or by visiting your members’ website. In addition to reaching out to your members of Congress on Twitter, consider targeting House and Senate leadership. You can keep NACo in the loop on your social media advocacy by being sure to include both @NACoTweets and #MIEP in your tweets.
|
Additional MIEP Resources
Learn More about the MIEP |
|
Estimated Cost of Health Care in Local Jails |
|
Learn More About the Medicaid Program |
|
Veterans in Our Local Justice System |

About Blaire Bryant (Full Bio)
Legislative Director – Health | Large Urban County Caucus
More from Blaire Bryant
-
Reports & Toolkits
NACo-NSA Joint Task Force Report: Addressing the Federal Medicaid Inmate Exclusion Policy
The Medicaid Inmate Exclusion Policy (MIEP), which denies or revokes federal health and other benefits, is a violation of the equal protection and due process clauses of the Fifth and 14th Amendments of the U.S. Constitution, respectively. -
Basic page
NACo Commission on Mental Health and Wellbeing
The NACo Commission on Mental Health and Wellbeing brings together county leaders from across the nation to take action to address the ever-growing mental health crisis from the county government perspective.
-
County News
County library teams up with jail to offer resources to incarcerated individuals
The Salt Lake County Library teamed up with the county jail to educate inmates on how to navigate the library, including using employment resources. -
Blog
The County Countdown – August 7, 2023
Every other week, NACo’s County Countdown reviews top federal policy advocacy items with an eye towards counties and the intergovernmental partnership. -
Reports & Toolkits
The Principles Quick Guide to Creating a Settlement Council
The Principles for the Use of Funds From the Opioid Litigation are nationally recognized guidance for states, counties and cities receiving money from the lawsuits against entities that contributed to the opioid epidemic. -
Reports & Toolkits
Planning Principles Toolkit
Tools, templates and strategic guidance for maximizing the impact of opioid settlement funds on your community’s opioid abatement priorities. -
Press Release
Counties Encouraged by White House Action on Mental Health Parity
County leaders invited to White House for announcement of new proposed rule -
Blog
The County Countdown – July 24, 2023
Every other week, NACo’s County Countdown reviews top federal policy advocacy items with an eye towards counties and the intergovernmental partnership.
Contact
-
Legislative Director – Health | Large Urban County Caucus(202) 942-4246
-
Legislative Director – Justice & Public Safety | Gulf States Counties & Parishes Caucus(202) 942-4234
Related News
-
BlogCMS proposes new minimum staffing standards for long-term care facilitiesSep. 11, 2023
-
BlogSenate HELP and House Energy and Commerce pass PAHPA reauthorizations out of committee with amendmentsAug. 18, 2023
-
BlogCommunity Mental Health Services May Support Reducing Jail PopulationsJul. 19, 2023
Related Resources
-
Reports & ToolkitsNACo Analysis: Overview of New Treasury Guidance for ARPA Flexibility LegislationAug. 11, 2023
-
Reports & ToolkitsThe Principles Quick Guide to Creating a Settlement CouncilAug. 1, 2023
-
Reports & ToolkitsPlanning Principles ToolkitAug. 1, 2023
Upcoming Events
-
3Oct2023Webinar
NACo Information Series on Treasury’s ARPA Flexibility Guidance: Relief from Natural Disasters
Oct. 3, 2023 , 2:00 pm – 3:00 pm -
4Oct2023
-
4Oct2023
More From
-
ARPA Impact Report: An Analysis of How Counties are Addressing National Issues With Local Investments
With American Rescue Plan funds, counties are strengthening America’s workforce, addressing the nation’s behavioral health crisis, expanding broadband access, improving housing affordability and building prosperous communities for the next generation.
Learn More
Contact
-
Legislative Director – Health | Large Urban County Caucus(202) 942-4246
-
Legislative Director – Justice & Public Safety | Gulf States Counties & Parishes Caucus(202) 942-4234