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The Legal Path to a Whole of Government Opioids Response

This project brings together researchers from the Center for Public Health Law Research and the Indiana University Robert H. McKinney School of Law, to identify a series of 84 actionable steps for government at all levels to improve and align drug policy in the United States.

The increase in serious opioid use disorder (OUD) and overdose deaths in the United States requires a response that coordinates multiple levels of government to mobilize their resources and expertise in an aligned and efficient fashion. 

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Drug Decriminalization Laws

More than one million people are arrested annually for drug possession across the United States. People charged with and convicted of criminal drug offenses can face devastating collateral consequences, including eviction, unemployment, loss of the right to vote, and deportation. Research shows that criminalization of drug possession contributes to the marginalization of people with substance use disorders, results in stark racial disparities, and costs billions of dollars.

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Incarceration Effects on Medicaid Status

The federal Medicaid Inmate Exclusion Policy (MIEP) generally prohibits federal matching funds from being used to pay for health care provided to most adults incarcerated in public institutions. For justice-involved individuals, this means that during incarceration the criminal justice system is responsible for inmate health care and that Medicaid enrollment may be either terminated or suspended, leading to gaps in Medicaid coverage at release.

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State Debt Collection Litigation Laws

Debt collection lawsuits have increased dramatically over the past few decades, now accounting for an estimated one in four of all civil cases. These lawsuits—which can include suits to recover student loan debt, medical debt, car loan debt, credit card debt, and more—are overwhelmingly resolved in favor of the debt collector. Debt and debt collection judgments can have severe and far-reaching consequences, including wage garnishment, bank account seizure, and inability to secure housing, employment, or medical care.

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