May 23, 2024

Cassidy Highlights Need to Protect Medicaid Access for Pre-Trial Detainees, Address Fentanyl Crisis

WASHINGTON – U.S. Senator Bill Cassidy, M.D. (R-LA) highlighted his Due Process Continuity of Care Act, which ensures pre-trial detainees are not kicked off Medicaid before being found guilty of a crime, today at a U.S. Senate Finance Committee Hearing on the fentanyl crisis. With Medicaid denying access to care, the responsibility for care for detainees struggling with addiction is shifted onto local jail budgets, resulting in unmet needs. Currently, pre-trial detainees comprise approximately two-thirds of people held in local jails.

“In my medical practice, I used to treat patients from jails. I used to go into prisons,” said Dr. Cassidy. 

“Someone who is currently booked into jail loses Medicaid benefits before being adjudicated. They may be said ‘not guilty,’ but they’ve still lost their Medicaid, and they have to go through the whole rigmarole to get back onto Medicaid,” continued Dr. Cassidy.

Local jail admissions resemble the emergency department, receiving those with the highest acuity of mental illness and substance use disorder. Most inmates in local jail have had a mental illness or substance use disorder diagnosis.

Tony Vezina, Executive Director of the 4th Dimension Recovery Center, echoed the need for passing the Due Process Continuity of Care Act and highlighted the financial burden placed on local law enforcement budgets. 

“In county jail systems, a person loses Medicaid and then the jail has to pay for the services. I’m not an expert on the criminal justice budget, but they don’t have the money to pay for adequate services. So leveraging Medicaid match for those behavioral health services would be ideal from a cost-savings perspective,” responded Mr. Vezina. 


Incarcerated people experience chronic diseases, mental illness, and substance abuse at higher rates than the general population. More than 95 percent of local jail inmates eventually return to their communities, bringing their health conditions with them.

Earlier this year, Cassidy was awarded the Major County Sheriffs of America’s (MCSA) Legislative Initiative Champion Award for his leadership on the Due Process Continuity of Care Act. The bill is endorsed by MCSA.

A modified version of the Due Process Continuity of Care Act was signed into law last Congress, but these provisions only applied to minors.