Senators Markey, Merkley Reintroduce Legislation to Protect Healthcare for Americans Who Cannot Afford Bail

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Washington (August 4, 2026) - Senator Edward J. Markey (D-Mass.), a member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, and Senator Jeff Merkley (D-Ore.) today reintroduced the Equity in Pretrial Health Coverage Act, legislation that would protect the continuity of federal health benefits under Medicaid, Medicare, Children's Health Insurance Program (CHIP), and Veterans Affairs for Americans who have been detained while they await trial and, in many cases, remain in custody because they cannot afford bail. These protections would make it easier for people to continue to access essential healthcare, including substance use disorder and mental health treatment, while incarcerated. The legislation would partially reverse the 1965 Federal Medicaid Inmate Exclusion Policy (MIEP), which generally bans the use of federal funds to provide care for inmates of a public institution under Medicaid.

"Healthcare is a human right. It is unjust and immoral to strip people of their health coverage simply because they can't afford to pay their bail," said Senator Markey. "Congress must eliminate the discriminatory policies that make it harder for people to get the healthcare they need, including treatment for substance use disorder or mental health services. I am proud to partner with Senator Merkley in fighting to break down barriers to essential healthcare and create a system that puts care and compassion over incarceration."

"Americans who have serious health conditions-including those who are awaiting trial-need access to quality health care and can't afford to be kicked off of those benefits," said Senator Merkley. "In America, you are innocent until proven guilty, and the?Equity in Pre-Trial Health Coverage Act?will ensure that pre-trial detainees can keep their health coverage and seek the medical treatment they need."

Currently, individuals who are arrested and can post bail maintain their coverage. But those who remain in custody because they cannot afford bail can lose coverage, despite being charged but not convicted of a crime. As a result, a gap in coverage exists for individuals covered by federal health programs awaiting trial, which restricts their access to essential care in their community and shifts the cost of medical treatment for pretrial detainees to local city, county, and state agencies. This gap is particularly challenging for people with substance use disorders and other mental health conditions, which require consistent and sustained medical treatment.

Cosponsors in the Senate include Senators Amy Klobuchar (D-Minn.), Tammy Baldwin (D-Wisc.), Cory Booker (D-N.J.), Elizabeth Warren (D-Mass.), and Alex Padilla (D-Calif.).

In 2022, Senator Markey secured provisions in the end-of-year spending package (Consolidated Appropriations Act, 2023) that allow states to maintain Medicaid coverage for juveniles who are in custody pending deposition of charges. The Equity in Pretrial Health Coverage Act would go further, extending and requiring coverage to anyone no matter their age.

Senators Markey and Merkley first introduced the legislation in 2021.

The Equity in Pretrial Health Coverage Act is endorsed by National Association of Counties, National Council for Mental Wellbeing, National Commission on Correctional Health Care, Association of Oregon Counties, Oregon State Sheriffs' Association, Major County Sheriffs of America, and American Jail Association.

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