Equity in Pretrial Health Coverage Act

S. 5231, the Equity in Pretrial Health Coverage Act, would change federal health-benefit rules so that people held in custody while awaiting resolution of criminal charges — that is, before conviction or other disposition — are not automatically cut off from Medicaid, Medicare, CHIP, or VA health benefits solely because of their custody status. Currently these programs generally exclude "inmates of a public institution" from coverage; the bill amends the relevant sections of the Social Security Act (Medicaid, Medicare, and CHIP) and directs the VA to revise its regulations so that this exclusion does not apply specifically during the pretrial period, before charges are resolved.

The bill affects pretrial detainees enrolled in or eligible for these programs — including CHIP-eligible children and pregnant women, and veterans — who would retain eligibility for federally covered health services while in custody pending disposition of charges, rather than losing coverage as soon as they are detained. It does not address people already convicted and serving a sentence, whose coverage exclusions under these programs are not changed by this bill.

The bill was introduced in the Senate on August 4, 2026, by Senator Edward Markey (D-MA) with several cosponsors, and referred to the Senate Committee on Finance. As an introduced bill, it would need to be considered and approved by that committee, then pass the full Senate and House, before being sent to the President. Most provisions would take effect the first calendar quarter beginning more than 60 days after enactment; the VA-related change would take effect immediately upon enactment.

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