Let’s end health care inequality in the justice system

As Vice President Kamala Harris recently declared to Midwestern voters, “We must fight for a future where every American has an opportunity to own a home, start a business, and build wealth.”

With less than 80 days until the election, Harris and Gov. Tim Walz must also start talking about specific policy solutions that will grow our economy, reduce inequality and help working people.

As governor of Indiana and in the U.S. Senate, I fought to help working-class families and strived to improve the quality of life for all Hoosiers and all Americans. Unfortunately, our justice system’s pervasive inequality works against these goals, particularly when it comes to people from economically disadvantaged communities.

From the moment of detention, pre-trial detainees face the risk of losing Medicaid coverage, despite the fundamental principle of being innocent until proven guilty. This increases costs to taxpayers and denies health care to people with addiction and mental health issues.

To address this issue, we must reform the system so that individuals in jail for minor offenses do not lose mental health benefits just because they can’t afford high bond fees.

Imprisoning people for minor crimes and then denying them access to mental health care perpetuates the cycle of incarceration and mental health struggles, increasing costs to the individual and taxpayer alike. It is essential to support the work of Sen. Cory Booker (D-N.J.) and Rep. Paul Tonko (D-N.Y.), who are working in Congress to bring about positive change.

According to the Indiana University Public Policy Institute’s detailed research on Marion County’s bail system, there are significant racial and wealth disparities. For example, the IU research finds that bail amounts for the same crimes are set 35 percent higher for Black defendants and 19 percent higher for Latino defendants compared to their white counterparts. The unfortunate reality is that minorities are also more likely to receive harsher punishment for low-level crimes.

But that’s not all. The journey to accessing treatment for individuals both during their incarceration and following their release is often challenging. The brunt of these problems is often faced by people who experience concurrent substance abuse and mental health disorders. An estimated 65 percent of people in prison suffer from substance use. But federal regulations limit how states can use Medicaid funds in correctional facilities, preventing many incarcerated individuals from getting the medical and mental health care they need to address their substance-use disorders.

Policy reforms are urgently needed to address the challenges faced by those incarcerated for nonviolent crimes. Fortunately, members from both parties in Congress are working towards making positive change. We should support their efforts.

In my home state of Indiana, there is a nonprofit entity that is picking up the pieces. Q360 Healthcare Alliance plays a crucial role in promoting the well-being and rehabilitation of incarcerated individuals. By providing access to comprehensive health care services and mental health support, this nonprofit facilitates reintegration into society. The model and mission that Q360 carries out should be the standard in jail systems across the country, ensuring incarcerated people have the best chance of a safe, healthy return into society.

Essential health care benefits should never be determined by one’s economic status. The status quo is bad for offenders and taxpayers alike. We should correct this now by allowing Medicaid to be used in our correctional systems.

Let’s support the efforts of individuals such as Sen. Booker and Sen. Tammy Baldwin (D-Wisc.) along with Reps. Tonko, Michael Turner (R-Ohio), John Rutherford (R-Fla.) and David Trone (D-Md.), who are working toward a legislative fix. It is time that we end the costly and unfair experiences that Americans undergo upon arrest, and work to rebuild our rehabilitation system for people who deserve a second chance.

Evan Bayh served as a senator from Indiana from 1999 to 2011 after serving as the 46th governor of Indiana from 1989 to 1997.