Due Process Continuity of Care Act
- Sponsor
- Rep. Turner, Sylvester [D-TX-18]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- Sep 8, 2025
Bottom line
This bill offers states the option to extend Medicaid benefits to individuals awaiting trial, aiming to improve healthcare access and continuity of care for a vulnerable population while incarcerated, supported by federal planning grants.
What it actually does
This bill amends the Social Security Act to grant states the option to extend Medicaid coverage to individuals who are in custody pending the disposition of their charges, thereby removing a long-standing exclusion. It also authorizes $50 million in federal planning grants to help states develop the necessary infrastructure and provider networks to implement this expanded coverage effectively.
Proponents argue
Proponents argue that extending Medicaid to pretrial detainees ensures continuity of care, particularly for those with chronic conditions or behavioral health needs, reducing health disparities and improving public health outcomes upon release. They highlight the 'due process' aspect, as these individuals are presumed innocent and should not be denied essential healthcare.
Opponents contend
Opponents might raise concerns about the potential financial burden on states, the administrative complexities of providing Medicaid services within correctional facilities, and the potential for increased federal spending. Some may also argue that healthcare for incarcerated individuals should remain solely a state or local responsibility, without federal involvement.
The bill is relatively short and clearly structured, making it accessible for a quick review by an informed reader.
Section 2(a)
Optional Medicaid Coverage for Pretrial Detainees
This provision amends Section 1905(a) of the Social Security Act to allow states the option to provide Medicaid coverage to individuals who are in custody pending the disposition of their charges. This change creates an exception to the existing Medicaid exclusion for inmates in public institutions, enabling states to cover healthcare costs for pretrial detainees.
Supporters argue
Supporters argue this ensures continuity of care for a population often with high healthcare needs, reduces the financial burden on local jails for medical costs, and aligns with the principle that individuals awaiting trial are presumed innocent.
Critics contend
Critics might argue this shifts costs from local correctional facilities to federal and state Medicaid budgets, potentially increasing overall healthcare spending without fully addressing underlying issues in the justice system.
Tradeoffs
This provision balances the desire to provide essential healthcare to a vulnerable population against concerns about federalizing costs traditionally borne by local governments and the administrative complexities of providing care in carceral settings.
Section 2(b) and 2(c)
Conforming Amendments and Effective Date
These subsections make necessary technical corrections to existing law, specifically Section 5122 of the Consolidated Appropriations Act, 2023, to align with the new state option for Medicaid coverage. They also establish the effective date for these amendments as the first day of the first calendar quarter that begins 60 days after the bill's enactment, applying to services furnished on or after that date.
Section 3
State Planning Grants for Medicaid Expansion to Detainees
This section authorizes the Secretary of Health and Human Services to award $50,000,000 in planning grants to states. These grants are designed to help states prepare applications to expand Medicaid coverage to pretrial detainees, covering activities such as assessing health needs, developing robust provider networks (including physical, behavioral health, and substance use disorder treatment), establishing electronic health record systems for billing, and ensuring quality of care.
Requires states applying for planning grants to assure the Secretary that they have consulted with relevant stakeholders, including state Medicaid agencies, managed care plans, healthcare providers, law enforcement personnel, officials from jails, and Medicaid beneficiary advocates, during the preparation of their application.
Section 3(b)(4)
Why it matters:It is standard legislative practice to include specific operational requirements for grant applications within the section authorizing the grants.
Case for: Ensures that state implementation plans are practical, address real-world challenges, and incorporate diverse perspectives from those directly affected or involved in the justice and healthcare systems, leading to more effective programs.
Case against: Could be seen as an additional administrative hurdle for states, potentially delaying the application process and increasing the initial workload for state agencies.
Estimated impact: Enhances the quality and feasibility of state plans and fosters broader buy-in from diverse stakeholders, improving the likelihood of successful program implementation.
Among the activities supported by planning grants is the development of state infrastructure to secure a process for an electronic health record (EHR) system for billing. This system is intended to reimburse for services provided by correctional facilities, outpatient providers, medical vendors, and contracted telehealth service providers to patients in custody pending disposition of charges, ensuring compliance with Medicaid requirements.
Section 3(c)(2)
Why it matters:Details regarding implementation support and technical infrastructure are often placed within the descriptions of grant programs designed to facilitate such development.
Case for: Essential for efficient billing, accurate data tracking, and ensuring proper reimbursement for a complex service delivery environment involving multiple types of providers within and outside correctional facilities, thereby facilitating financial sustainability.
Case against: Implementing compliant EHR systems can be a significant technical and financial challenge for states and correctional facilities, particularly smaller ones, potentially requiring substantial investment and expertise.
Estimated impact: Facilitates the financial sustainability and operational efficiency of the expanded Medicaid program by streamlining billing and record-keeping processes.