Author

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Blaire Bryant

Legislative Director, Health | Large Urban County Caucus
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Brett Mattson

Legislative Director, Justice & Public Safety
Naomi Freel

Naomi Freel

Legislative Associate

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Advocacy

County Countdown – April 21, 2025

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 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. 

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.

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

Related News

Department of Justice
Advocacy

DOJ terminates justice and public safety-focused grants

On April 22, the U.S. Department of Justice’s largest grant-making arm—the Office of Justice Programs—abruptly cancelled hundreds of grants awarded to county governments and other local jurisdictions and organizations. Approximately 365 grants have been identified for termination, which were estimated to be valued at $811 million at the time of awarding; it is unclear how much funding remained at the time of termination.

Stethoscope on dollars
Advocacy

NACo offers new Medicaid resources as Congress advances Budget Resolutions with major Medicaid reform implications

On April 10, the U.S. House of Representatives voted to adopt a Senate-passed budget resolution, marking the next step in the budget reconciliation process. The proposed funding levels therein represent significant potential cost shifts to counties, particularly in the area of Medicaid financing. To help county leaders understand what’s at stake, NACo has developed two new resources.

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Advocacy

County Countdown – April 21, 2025

Every other week, NACo's County Countdown reviews top federal policy advocacy items with an eye towards counties and the intergovernmental partnership. This week features the ARPA reporting deadline, a budget reconciliation update and more

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Advocacy

U.S. House reintroduces legislation to address the Medicaid Inmate Exclusion Policy

Two bipartisan bills aimed at addressing the Medicaid Inmate Exclusion Policy (MIEP) were recently reintroduced in the U.S. House of Representatives.

Medicines in hand
Advocacy

House E&C Committee advances SUPPORT Act reauthorization

On April 9, the U.S. House Energy and Commerce Committee marked up the SUPPORT for Patients and Communities Reauthorization Act of 2025. The bipartisan bill aims to reauthorize critical programs that target overdose prevention amid the renewal of the opioid crisis Public Health Emergency declaration.

birdflu
County News

Bird flu update: What county leaders should know

As of April 7, there have been 70 confirmed cases of bird flu in the United States, but no person-to-person spread has been detected. 

Upcoming Events

public health
Webinar

Federal Reforms to Medicaid Financing: What Counties Should Know (Part 2)

This two-part webinar series will examine the vital role Medicaid plays in supporting county-administered behavioral health and primary care services.

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Webinar

Ask a Public Health Expert: The Resurgence of Measles

Join NACo on Thursday, May 15 at 2 p.m. ET for a webinar on the resurgence of measles and what county leaders need to know. As outbreaks emerge across the U.S., this session will cover the history of measles, the importance of vaccination, current trends and how counties can respond effectively. The hour-long webinar will feature a 30-minute expert presentation followed by 20 minutes of audience Q&A. Don't miss this opportunity to hear from public health experts and get your questions answered.

Aerial view of Boiling Springs, S.C.
Webinar

Impacts of Federal Immigration Policy on Local Governments (Part 2)

Hosted by the Local Government Legal Center (LGLC), join us for a second informational (not for CLE) webinar regarding the executive orders issued this year and federal policies in the area of immigration and how they may impact local governments and local government officials. Presenters will provide a high-level overview of the laws at issue and their impact on local government operations and duties.