John,

Imagine this: your doctor delivers life-changing news—a devastating diagnosis. Your health is failing, work hours are cut, and your future feels uncertain. But you have Medicaid, your lifeline to the care you need.

Then, the unthinkable happens. You’re accused of a crime, unable to afford bail, and held in jail awaiting trial. Suddenly, the Medicaid you relied on disappears. Why? Because under the Medicaid Inmate Exclusion Policy (MIEP), incarceration—even without a conviction of guilty—means losing your healthcare. Stripped of coverage at the moment you need it most. This is reality for thousands of Americans every year and it must stop. 

Tell Congress that applying MIEP to people who haven’t been convicted of a crime is not right: Sign the petition to support the Due Process Continuity of Care Act.

Sign the Petition

MIEP was meant to prevent states from shifting incarcerated individuals’ medical costs to the federal government, but it has had devastating consequences. Around 69% of people in city and county jails—roughly 450,000 individuals—are in pretrial detention, not because they’ve been convicted, but because they can’t afford bail. Yet, the moment they’re behind bars, federal law strips them of the healthcare they previously had.

That alone is alarming, but the deeper truth is even worse—MIEP is actively harming the health and safety of those awaiting trial:

• Healthcare Disruptions – Many incarcerated individuals suffer from chronic illnesses, mental health conditions, and substance use disorders. MIEP disrupts their access to treatment, leading to worse health outcomes.

• High Overdose Risk Post-Release – Studies show that individuals leaving incarceration are 129 times more likely to die from a drug overdose in the first two weeks after release due to a lack of continuity in care.

• Increased Recidivism – Without access to healthcare, including mental health and addiction treatment, individuals are more likely to end up back in the criminal justice system.

The Due Process Continuity of Care Act hopes to close this blaring loophole; it would amend MIEP to ensure that legally innocent individuals maintain access to Medicaid — guaranteeing they get their healthcare needs addressed even while awaiting trial.

Bail or jail, no one deserves to lose Medicaid coverage without due process.

Dream.Org, through its Public Health is Public Safety campaign, is working alongside key allies to end punitive drug and criminal justice policies that punish rather than treat those struggling with substance use. Time and again, punishment-first approaches have failed—worsening the crisis instead of solving it.

A vast majority of people in pretrial detention come from vulnerable, low-income communities. They can’t afford bail, many struggle with mental and physical health issues, and substance use disorders are common. Yet, MIEP strips them of critical healthcare, harming both their well-being and burdening state and local governments.

MIEP is not just cruel—it’s a denial of due process. It’s time to end it. Sign the petition and tell your lawmakers to act now.

Stand Up for Due Process

In solidarity,
— Dream.Org