National Sheriffs’ Association and National Association of Counties Applaud Federal Leaders Action on Mental Health

Thursday, February 13, 2020

WASHINGTON – The National Association of Counties (NACo) and the National Sheriffs’ Association (NSA) today commended President Trump’s 2021 proposed budget which includes provisions that would prevent the termination of Child Health Insurance Program (CHIP) benefits for inmates and Medicaid coverage for pre-trial inmates for six months.

Last year, NACo and NSA established a joint task force on pre-trial detainee health care and recidivism. The task force advocates for legislation and action to secure federal health benefits for those arrested and jailed, but not convicted of a crime. The Social Security Act prohibits use of federal funds and services, Children’s Health Insurance Program (CHIP) and Medicaid, for medical care provided to “inmates of a public institution.” This federal law, known as the "Medicaid Inmate Exclusion Policy" does not differentiate between a convicted inmate and a person incarcerated prior to conviction. Legislation has been introduced in the U.S. Senate by Senators Ed Markey (D-Mass.) and Jeff Merkley (D-Ore.) that would repeal the Medicaid inmate exclusion which strips individuals of their benefits when incarcerated. 

“We applaud the administration and congressional leaders for taking action on this important issue and sheriffs call on Congress to pass legislation with the President’s signature that would ensure that these benefits remain in place,” said NSA President Daron Hall. “Jails have become the de facto mental health facilities in this country and people need to get the care they need while awaiting trial.”

“We commend the administration for including provisions in the proposed budget that would preserve constitutional rights to those arrested, presumed innocent and not convicted of a crime,” said National Association of Counties Executive Director Matthew Chase. “Prohibiting states from terminating CHIP and Medicaid coverage for pre-trial inmates will help counties break the cycle of recidivism, produce better outcomes for individuals and make our communities safer. We look forward to working with the administration and Congress to advance our efforts to ensure continuity of care for some of our most vulnerable residents.”

By the numbers:
• 40 percent of jail inmates have a chronic medical condition
• 44 percent of jail inmates have been diagnosed as having a mental disorder
• 63 percent of jail inmates have a substance use disorder
• 70 percent of the 2 million youth arrested every year in the U.S. suffer from a mental health condition
• 96 percent of jail detainees and inmates do not receive a prison sentence and return to the community

An upcoming report by the NACo-NSA joint task force will detail the harm done by the federal Medicaid Inmate Exclusion Policy and lay out steps governments can take to address the problem.


The National Association of Counties (NACo) strengthens America’s counties, including nearly 40,000 county elected officials and 3.6 million county employees. Founded in 1935, NACo unites county officials to advocate for county government priorities in federal policymaking; promote exemplary county policies and practices; nurture leadership skills and expand knowledge networks; optimize county and taxpayer resources and cost savings; and enrich the public’s understanding of county government.

The National Sheriffs’ Association is one of the largest associations of law enforcement professionals in the U.S., representing more than 3,000 elected Sheriffs across the nation, and with a total membership of more than 20,000. NSA is a non-profit organization dedicated to raising the level of professionalism among Sheriffs, their deputies, and others in the field of law enforcement, public safety, and criminal justice. Throughout its seventy-eight year history, NSA has also served as an information resource for all law enforcement, as well as State governments and the Federal government.