Policies for waiving medical copays in prisons are not enough to undo the harm caused by charging incarcerated people for health care access

Our review of copay policies show that exemptions are so limited, ill-defined, and inconsistent that they fail to make the copay system less harmful for incarcerated people.

by Emily Widra and Dr. Emily Lupez, May 15, 2025

In most states, people incarcerated in prisons must pay medical “copays,”¹ which are essentially fees to access health care including physician visits, medications, dental treatment, and other health services. While these fees may seem reasonable at two or five dollars, research shows they actually act as barriers to health care for incarcerated people who typically earn less than a dollar an hour, if they are paid at all. Prison administrators claim these fees deter the “overuse and abuse” of limited health care resources,² and have countered critiques by including waivers and exceptions in their copay policies and insisting that no one is denied care because they can’t afford to pay. However, our review of these policies and evidence from a recent study show that these exemptions are so limited, ill-defined, and inconsistent that they fail to make the copay system fairer and less harmful for incarcerated people. Instead, these exemptions lend a veneer of rationality to prison medical fee policies — which are known to limit access to care — ultimately helping to perpetuate them.

We reviewed each state’s prison copay policy, including any waivers or exemptions, to build upon the initial findings of Dr. Lupez and her colleagues, which indicated that copay waivers are likely not working as intended. They found that, despite two-thirds of states that charge copays having chronic condition waivers, people with chronic conditions in states charging copays were substantially more likely to have never seen a doctor since admission compared to those in states without copays.³ If copay waivers were being applied routinely and consistently, we would expect people without a chronic condition (i.e., people ineligible for a chronic condition waiver) to be more likely to have never seen a doctor since incarceration, but this was not the case, implying that these waivers are not promoting healthcare access for some of the most vulnerable people in prison.

In research published in 2024, Dr. Lupez and her colleagues found that among people incarcerated in state prisons for any amount of time, more unaffordable copays were associated with worse access to the necessary healthcare, like obstetrical examinations for pregnant people and seeing a medical provider for people with chronic medical conditions. For more details, see New research links medical copays to reduced healthcare access in prisons.

To better evaluate how copays and copay exemptions function in prison systems, we analyzed policies from all states charging medical copays and the federal Bureau of Prisons. While we cannot estimate the frequency with which care is actually exempt from copays, our analysis of the various policies reveals that copay waivers are inevitably inconsistently⁴ or retroactively applied,⁵ unclear to incarcerated people,⁶ and frequently left up to the discretion of a single healthcare provider, administrator, or other correctional staff.⁷ This helps explain why incarcerated people may expect to be charged a burdensome fee every time they seek medical care, regardless of potential exemptions, and in turn, how that fee functions as a significant barrier to healthcare access.

Key findings from our study of prison copay policies

Almost all state prison systems charging copays have policies outlining exemptions for some healthcare services for some incarcerated people. Among the 40 prison systems still charging these fees, the exemptions can be based on any number of factors including how the care was requested,⁸ the specific health condition,⁹ the type of medical care required,¹⁰ and the circumstances leading to treatment.¹¹ Ultimately, we find that copay waiver policies frequently rely on the discretion of individual healthcare providers or correctional staff and are far too limited and have far too many caveats to meaningfully counteract the harmful deterrent effect of copays on healthcare access.

Below, we highlight the most striking examples from our analysis that illustrate why waivers or exemptions still fail to ensure appropriate and equitable access to the care people need.

Staff-initiated versus patient-requested care. In most states (33), incarcerated people are expected to pay a fee if they request their own medical care, but medical care requested or initiated by healthcare staff, correctional staff, or facility administrators is exempt from fees.¹² In some cases, this reflects standardized or systems-based visits like mandatory tuberculosis testing, which is more aligned with the priorities of the carceral system (i.e., infection control) than patient needs. Staff-initiated visits force incarcerated people to rely on the prison medical system to monitor when preventative care or chronic health condition follow-ups are due, a process likely hindered by staffing shortages and the absence of sufficient medical record systems.¹³ Exemptions for care initiated by correctional staff — such as a request for a mental health evaluation — require incarcerated people to depend on correctional staff to access healthcare services, compromising patient privacy — when medical information has to be shared with non-medical staff — and establishing a system where staff exert control over who gets seen by medical providers, undermining patient autonomy.

Medical emergencies. Only 27 prison systems include an explicit exemption for emergency treatment, and in most of those states, the emergency is defined by either healthcare providers¹⁴ or departmental staff,¹⁵ not the person actually experiencing the medical emergency.¹⁶ In seven states with medical fees, incarcerated people are required to pay the fee for emergency medical care if the injury or illness is determined — by medical staff, correctional staff, or in a disciplinary hearing¹⁷ — to be self-inflicted.¹⁸ An additional two states specify that care provided for self-inflicted injuries are subject to copays (although do not specifically mention emergency medical care). At least one state (Michigan) requires the incarcerated person to pay all costs associated with the treatment of injuries and illnesses determined to be self-inflicted, which is inevitably above and beyond the initial fee for health services; essentially, such policies use medical fees as additional punishment for accidents, self-harm, and mental illness.¹⁹ In our survey of state policies, we only found two states with policies specifying that people with serious mental illness could be exempt from the fees associated with medical care for self-harm²⁰ and only one other state (Texas) that exempts medical treatment for all self-inflicted injuries from medical fees. Policies charging fees for medical care needed for self-inflicted injuries are particularly cruel given the mental health harms caused by incarceration itself. In states that punish self-harm this way, incarcerated people not only have to suffer these injuries — they must also financially pay for them.

Work-related injuries. Almost half of prison systems that charge copays (17) have some exemption for medical care associated with work-related injuries. In some prison systems, only the initial medical treatment for a work-related injury is exempt,²¹ and in others, the treatment for work-related injuries is exempt from the medical fee only if it is a medical emergency.²² In some prison systems, the treatment for work-related injuries is only exempt if it was reported at the time of the injury and is verified by an incident report (filed by correctional staff).²³ Like the exemption for emergency care, this exemption relies entirely on the accuracy and timeliness of staff reporting workplace incidents. It’s also worth noting that incarcerated workers generally do not have the workplace health and safety protections that people do outside of prisons (such as those enforced by the Occupational Safety and Health Administration or similar state programs). They are also often exposed to dangerous work conditions. So it’s remarkable that when incarcerated people are injured under work conditions controlled by the prison system itself, they are often still assessed medical fees and experience lost wages, given the lack of standard labor protections like sick leave.

Chronic health conditions. While most states (26) have exemptions related to care for chronic health conditions like cardiovascular disease, diabetes, HIV, or mental illness, many (17) of these exemptions only apply if the appointment is scheduled by a health care provider or as a part of a recurring “clinic,” not if the individual seeks additional care outside of previously scheduled appointments.²⁴ Someone who meets the exemption criteria may also need to pay copays for the initial two or three nursing sick call visits before clinicians identify them as someone who should be exempt from copays.²⁵ In Alaska, for example, people with chronic conditions are charged a $5.00 fee for their initial provider visit and $5.00 every year “for ongoing treatment of the chronic condition.” At least three states (Georgia, Indiana, and Oklahoma) mention an exemption for fees associated with prescriptions for chronic conditions, but do not exempt chronic condition-related provider visits or other treatments from the fee.²⁶ People in state prisons suffer disproportionately from chronic health conditions when compared to the total U.S. population, and financial barriers to treatment will only exacerbate the poor health outcomes of incarceration.²⁷

Pregnancy-related care. In 18 prison systems, some or all of the care related to pregnancy is exempt from copays. In some states, like Arizona and New Hampshire, they are only exempt from copays for pregnancy-related medical care (i.e., they would not be exempt from copays for treatment for a non-pregnancy-related illness or injury).²⁸ Five states and the federal Bureau of Prisons only exempt prenatal care (care while pregnant) with no mention of delivery-related care or postpartum medical care.²⁹ At least three states explicitly exempt postpartum medical care from copays.³⁰ About 4% of people (or 3,500) in women’s prisons in 2016 — disproportionately women of color — were pregnant at admission, and many of them did not received the basic prenatal care you would expect, like an obstetric exam, medication, special diets, testing, or pregnancy education. Given that many prison systems seem to have limited or no policies exempting pregnant people from medical copays, many may not seek care during their pregnancy. Combined with a lack of robust healthcare resources in prison to identify people in need of care, it’s no wonder many pregnant people are not receiving necessary medical care.

Menstrual health. Only one state’s copay exemption policy makes any mention of menstrual health: in Arizona, people “who require additional feminine hygiene products due to medical issues” can complete a form and submit it to Health Services, and the copay is waived for the subsequent medical appointment. Only half of state prison systems (25) are required by law to provide menstrual products, and only 18 of those systems are obligated to provide those products for free.³¹ Not only do many women have to pay for their menstrual products, but they also must pay for any healthcare related to problems caused by inadequate access to menstrual products. For the more than 85,000 women in prison in 2023, inadequate access to period products and reproductive healthcare can have serious health consequences, and almost every single prison copay policy fails to even address menstrual health.

Substance use. Only eight states and the federal Bureau of Prisons explicitly exempt substance use related healthcare from medical copays. Even when healthcare providers refer people to substance use treatment, incarcerated patients are frequently charged for their initial request for an appointment with the provider, and many incarcerated people may not know how to access treatment without being charged copays and fees. Any perceived barrier to accessing substance use treatment behind bars has serious consequences for the more than half-million people in prison who reported a substance use disorder in the year before their admission.³²

Vaccinations. About one-quarter of prison systems with copays (13) waive them for vaccinations explicitly. Even when vaccinations are exempt from copays, there are often additional caveats: in West Virginia, the waiver only applies to vaccinations and preventative care “provided or made available to all inmates.” While these exemptions may clearly apply to the distribution of the COVID-19 vaccine in 2021, it is unclear how this may play out when an incarcerated person requests a specific vaccine that may not be offered to the entire facility population, like the HPV vaccine,³³ the pneumococcal vaccine,³⁴ or Hepatitis B vaccine.³⁵

In addition to these highlighted findings, we have categorized the state copay policies we found according to the conditions or types of medical care that are exempt (and under what circumstances) and compiled this information in our appendix table.

Conclusion

“Copay” fees for medical care in prison are unaffordable at prison wages. They deter necessary care for an incarcerated population that faces many medical conditions — often at higher rates than national averages — and that routinely receives inadequate health services behind bars. The copay waiver policies ostensibly meant to “fix” this problem of copays deterring necessary care are, in many states, extremely limited with only a handful of care types or medical conditions exempted. Oftentimes, the exemptions are so ill-defined and inconsistent that it is hard to imagine any fair, consistent implementation of these policies. Many incarcerated people may be unaware that such waivers exist at all; even if they are aware, the complexity of the waiver criteria makes it nearly impossible for them to determine whether, when, or how a waiver might apply to their care.

Ultimately, we conclude that these copay exemption policies fail to make the copay system any less harmful for incarcerated people, especially the large number of incarcerated people with chronic medical needs. Instead, these exemptions simply give cover to prison systems that limit access to care and prioritize their bottom lines by imposing medical fees on a largely poor, medically vulnerable population with no other options.³⁶ Rather than tinkering with the edges of these policies through waivers and exemptions, prison systems should drop copays altogether.

WEBINAR: Fighting Jail Expansion: Lessons from the Front Lines

Learn how advocates are responding to shifting arguments for new jail construction.

by Emmett Sanders, May 14, 2025

For decades, calls for new jail construction were largely accompanied by “Tough on Crime” rhetoric that ignored the fact that jails often house the most precariously situated members of our society. While these dehumanizing narratives persist, in many places jail construction has taken a carceral humanist turn that depicts cages as places of care and compassion and the jail as a service provider for those with mental health or substance use support needs.

This is just one of the ways in which arguments for new jail construction have evolved over time, leading communities to spend millions and sometimes even billions of dollars on new jail construction, even as public safety initiatives are being viciously defunded. Fortunately, those on the frontlines who oppose new jail construction have evolved their own arguments and have developed new strategies to push back.

On June 11, 2025, Prison Policy Initiative brought together a panel of activists who have pushed back against jail expansion in communities from Atlanta, Georgia, to Sacramento, California, all the way to Oahu, Hawai’i. We discussed how arguments for new jail construction have shifted over time, went over some useful strategies and tools for responding to these arguments, and talked about how our advocacy department can help support efforts to challenge new jail construction in your area.

Panelists included:

• Carrie Ann Shirota: Policy Director, ACLU-HI with the Reimagining Public Safety in Hawai’i Coalition
• Liz Blum-Gutierrez: Co-founder Decarcerate Sacramento
• Michael Collins: Senior Director of Government Affairs, Color of Change with the Communities Over Cages Coalition

Watch the full webinar:

Webinar Resources

• Webinar Slides

Additional Resources

• Does our county really need a bigger jail? – contains important questions to ask when jail construction is being discussed in your area
• Jail expansion toolkit – offers useful tips for opposing jail construction, including advice on reading jail needs assessments
• If They Build It: Organizing lessons and strategies against carceral infrastructure – lessons learned and recommendations for opposing carceral infrastructure from Community Justice Exchange

Gov. Abbott’s bail proposals would make communities less safe, drain taxpayer dollars, and worsen racial disparities

The proposals before the Texas legislature would dramatically increase the state's already bloated jail populations.

by Sarah Staudt, May 14, 2025

This week in Texas, Governor Greg Abbott and conservative lawmakers are trying to change the state constitution to enshrine the worst features of the current bail system. These proposals, if passed and then approved by voters, would cause a rise in Texas’ already bloated jail populations. As a result, more people will be detained in private prisons out of state, taxpayers will be saddled with huge expenditures, and public safety and public health will get worse.

Disturbingly, proponents of these measures are calling them “bail reform” when in fact they are the exact opposite. “Bail reform” generally refers to the effective policies enacted around the country to make bail processes fairer and to reduce pretrial jail populations. A system of wealth-based detention that determines who should be in jail based on how much money they have in their bank accounts is an illogical and ineffective policy. Efforts to change or eliminate these money bail systems in Illinois, New Jersey, and elsewhere have been highly successful, have not led to rises in crime, and have saved communities countless millions of dollars in bail payments.

Texas conservatives are proposing to do the opposite. The proposals would make it mandatory in many cases for judges to hold people until their trials without bail, and in other cases would require the use of monetary bail in situations where people are currently being released without needing to pay any money. It is vital that Texas legislators and voters oppose these regressive policies, and that activists around the country understand the negative impacts of these kinds of changes to bail systems.

Overusing pretrial jailing undermines fairness and harms public safety and public health

Decades of research shows that growing the pretrial jail population is a mistake that will harm the justice system, public safety, and public health. There is ample evidence that lower jail populations do not harm public safety. Moreover, the overuse of pretrial jailing destabilizes both the individuals who are incarcerated and their communities, stoking the root causes of crime and harming public safety in the long run.

Individuals in custody are affected in a variety of negative ways by pretrial jailing. People incarcerated pretrial are more likely to:

• lose their jobs and experience housing instability;
• commit suicide, and are more likely to overdose after release;
• become re-involved in the criminal legal system in the future, as measured by long-term re-arrest rates;
• fail to appear in court;
• be convicted and be sentenced to longer jail and prison terms, worsening prison overcrowding and mass incarceration as a whole.

Overuse of pretrial jailing also harms the fairness of the criminal legal system as a whole by worsening racial disparities and disproportionately impacting women. People in poverty and Black and brown people are less likely to be able to afford bail, and bails are set at higher rates for Black and Latino people. Women are also less likely to be able to afford monetary bail when it is set (even though bail is set at lower amounts for them). Black people are less likely to be released on their own recognizance and more likely to be detained without bail. Texas already imprisons Black people in jails at disproportionate rates, and expanding pretrial jailing is likely to worsen that problem.

A deeper dive into the regressive bail package

The package of regressive measures being pushed in the Texas legislature consists of three parts (known as SJR 5, SB 9 and HB 75, and SJR 1). The exact language of these measures has been changing daily, but the core problems of each provision remain the same.

SJR 5 expands no-bail jailing without due process

SJR 5 would change the Texas constitution to allow detention without monetary bail for a wide variety of charges. The United States Supreme Court has been clear for decades that detention before trial, particularly without bail, should be a “carefully limited exception.” The federal government and states that have reduced or eliminated monetary bail, like Illinois and New Jersey, have tried to ensure that no-bail detention is “carefully limited” by restricting the charges for which it can be used and enshrining important due process protections in the law. However, Texas’ recent proposals would expand jailing without these careful limitations.

Although the exact provisions of SJR 5 are changing almost daily, many of the drafts have lacked key due process protections. It is vital that any version of SJR 5 that advances includes basic provisions that ensure that detention decisions are fairly made and that jail is only used as a last resort. Some of those key provisions would include:

• Limiting the availability of no-bail detention only to serious, violent cases, rather than allowing it in broader categories of charges;
• Ensuring that everyone who may be jailed without bail has access to counsel.
• Ensuring that prosecutors be held to a high standard of proof that a person will pose a danger to others — “clear and convincing” evidence, rather than simply a “preponderance” of evidence.
• Requiring that detention based solely on risk of fleeing the jurisdiction hinges on whether someone is likely to willfully flee prosecution. If no-bail detention is allowed based solely on whether someone is likely not to appear in court through no fault of their own, it will increase the unnecessary detention of poor and unhoused people, who sometimes struggle to find transportation and other resources necessary to appear for their court dates.
• Requiring that jail only be used if there is no less restrictive set of conditions that could protect the public. No-bail jailing should always be a last resort, and should only be used if there are no other alternatives.

Without these key due process protections, increasing no-bail detention is likely to lead to more people being held in jail longer, increasing jail populations without improving public safety.

SB 9 and HB 75 entrench the use of monetary bail

While SJR 5 seeks to increase the number of people held without bail, SB 9 and HB 75 seek to use monetary bail even more often than it’s currently being used. These bills would undo progress that has been made in reducing the use of monetary bail in Texas localities like Harris County.

SB 9 and HB 75 would require the use of money bail in many cases, including misdemeanors. Currently, people are often released on these charges without having to pay money. A particularly disturbing set of cases included in SB 9 and HB 75 are so-called “terroristic threat” cases. Although these charges sound very serious, they actually include any threat to people or property that causes an official or volunteer emergency agency to respond. This can include misdemeanors that often are charged against school-aged children because of social media posts. Including these non-violent charges in the set of charges where money bail will be required will do nothing to improve public safety — but it will ensure that poorer accused people are stuck in jail more often.

These bills also create procedural barriers that will prevent people from being released pretrial in a timely fashion. As we have noted, even one day in jail can lead to a range of negative outcomes. First, the proposals restrict the ability of magistrates and law hearing officers to set bail, and these kinds of decision makers play a key role in how large municipalities make bail decisions quickly. Second, it allows prosecutors to unilaterally prolong detention even when a judge intended to set an affordable bail. Prosecutors would be allowed to appeal these decisions, claiming that bail was set too low, and strand people in custody while the appeal is pending.

SJR 1 targets immigrants with mandatory jailing

The last provision in this regressive bail package combines the harms of the immigration system with the harms of the criminal legal system, requiring no bail detention for a group of people the proposal refers to as “illegal aliens.” The definition of “illegal aliens” has changed in various drafts of the proposal, but includes DACA recipients (so-called “dreamers” who entered the United States as children) and asylum seekers. Because criminal legal system statistics are not broken up by immigration status, it is impossible to estimate how many people this will affect, but it will certainly have a disproportionate impact on Texas’ Latino residents.

Because the proposal requires detention even in non-violent cases, judges will be barred from considering individual facts and circumstances. As a result, they will end up detaining people who do not pose a threat to anyone or who are charged with weak cases that are unlikely to lead to a conviction. Even when a judge decides that a person can be safely released to await trial in the community, the law will overrule that judgment and require them to send the accused person to jail. In other words, the measure ties the hands of the very people who are entrusted with the responsibility of ensuring that the criminal legal system is administered fairly. Judges hearing individual cases — not legislators in Austin — should make these decisions.

SJR 1 would also unnecessarily burden Texas taxpayers and local governments with the cost of incarcerating undocumented people who, under current law, would instead be detained by the federal government. Under federal law, many undocumented people charged with a wide variety of crimes are already required to be held in immigration detention. By requiring no-bail detention in their criminal cases as well, SJR 1 shifts the burdens and costs of incarcerating those people from the federal government to local jails — all without providing any additional funding to localities to absorb these costs.

Regressive bail policies will worsen Texas’ already out-of-control pretrial jailing crisis

Texas cannot afford to adopt these regressive policies. The state is already well above the national average for incarceration rates overall, and its pretrial jail population has been rising steadily for decades. This creates a serious overcrowding problem in Texas jails; 41% of Texas counties already send incarcerated people to other counties or states while awaiting trial. Harris County alone spends more than $50 million per year on out-of-state jail contracts. These expensive arrangements are often made with private prison companies, costing Texas taxpayers more money while enriching private corporations. To be clear, this problem cannot be solved by building bigger jail facilities — in most cases, it is a lack of staff, not a lack of bed space, that leads counties to outsource pretrial incarceration.

Expanding pretrial jailing will also cost lives. Deaths in jails are on the rise across Texas, and the situation is worsened when people are sent out of state, since those facilities do not have to follow standards set by the Texas Commission on Jail Standards, nor do they have to follow death reporting and investigation rules.

Lawmakers are voting on these proposals in the next few days, and there are real opportunities to stop them from moving forward, or to push for important revisions that strengthen due process protections. There will also be an opportunity for Texans to voice their opposition to SJR 5 and SJR 1 at the polls if they do advance past the legislature. Texas deserves true reform measures that seek to reduce harmful pretrial jailing, rather than so-called “tough-on-crime,” anti-immigrant measures masquerading as “bail reform”.

New data on pregnancy prevalence, outcomes, and programs in prisons are welcome additions, but raise new questions

The Bureau of Justice Statistics published 2023 data on pregnancy prevalence and outcomes in prisons, as well as the prison systems that offer relevant prenatal and postnatal accommodations, supports, and programming.

by Emily Widra and Emmett Sanders, May 7, 2025

A new Bureau of Justice Statistics report offers updated data on pregnancy among people in state and federal prisons. This important new dataset includes the prevalence of pregnancy among incarcerated people, pregnancy outcomes, and some limited data on the types of services, medical care, and support offered to incarcerated pregnant people. The findings from Maternal Healthcare and Pregnancy Prevalence and Outcomes in Prisons, 2023 are based on data collected for the first time in 2024 as a supplement to the annual National Prisoner Statistics survey. While this report is a welcome contribution to a shamefully understudied experience during incarceration, the data it provides raises almost as many questions as it answers.

Women’s incarceration has grown at twice the pace of men’s incarceration in recent decades but there is often too little data to explain this growth or to elaborate the specific effects incarceration has on women and their health, including their experience of pregnancy.¹ Previously, the most recent national data on pregnancy in prisons from the Bureau of Justice Statistics was collected in the Survey of Prison Inmates in 2016 and was published in 2021. Since then, researchers from Johns Hopkins University collected detailed data on pregnancy outcomes in a smaller set of 22 state prison systems and the federal Bureau of Prisons from 2016 to 2017 as part of the Pregnancy in Prison Statistics (PIPS) study. Even though the PIPS study covered only about half of state prison systems surveyed by the Bureau of Justice Statistics, the findings offered a closer look at pregnancy outcomes in prison than were available from the Survey of Prison Inmates. In this new publication, the Bureau of Justice Statistics surveyed 50 state departments of corrections and the federal Bureau of Prisons regarding:

1. the number of pregnancy tests provided and found positive upon admission to prison,
2. the number of pregnant people in prison at year-end,
3. the outcomes of the more than 700 pregnancies that ended in prison in 2023, and
4. the availability of specific kinds of pre- and post-natal support across jurisdictions.

Yet the data raises a series of new questions. There are unexplained differences in the prevalence of pregnancy behind bars compared to the PIPS report, as well as a lack of basic data on the outcomes of live births, and a failure to report how often pregnancy-related services and accommodations are actually used. The report also helpfully touches on services like prison nursery programs; however, crucial details about their implementation are left out — a gap we attempt to fill in this briefing using our own research. This new report is a step in the right direction, but much more work needs to be done to provide an accurate and useful portrait of pregnancy in prison.

Fewer people in prison report being pregnant when entering prison

The prevalence of pregnancy in prisons is measured in two ways: the number of pregnant people admitted to prison over the course of the year and the number of pregnant people in prison on a single day. The Bureau of Justice Statistics reports that 2% of women tested upon admission were pregnant in 2023.² This is surprisingly low compared to findings from previous data collection. In 2016, twice as many women (4%) admitted to prison each month were pregnant, according to the Pregnancy in Prison Statistics (PIPS) study. Past surveys from the Bureau of Justice Statistics that asked incarcerated women whether they were pregnant at admission (regardless of what year they were admitted) also found higher rates, from 6% in 1991 to about 4% in 2016. While the PIPS project surveyed only 22 state prison systems, it seems unlikely that this difference in the sample would explain the inconsistency in the data.³

We see this same issue in the point-in-time count of incarcerated pregnant people. According to the Bureau of Justice Statistics, on a single day in 2023 , there were 328 pregnant people in state (0.5%) and federal (0.3%) prisons, representing a total of 0.5% of all women in prison. This is much lower than we would expect based on the 2016 Pregnancy in Prison Statistics (PIPS) data, which found there were 350 pregnant people in just the smaller group of state (0.7%) and federal (0.3%) prisons they surveyed, for a total of 0.6% of the combined prison population. In other words, the actual number of pregnant incarcerated people was higher in the PIPS report that covered half as many state prison systems (22 states) as the Bureau of Justice Statistics report. It’s unclear what accounts for this substantial difference in the datasets.

The new Bureau of Justice Statistics report also offers new data on the race and ethnicity of pregnant people in prison on a single day. Compared to the overall population of women in prison,⁴ white, Black, American Indian and Alaska Native, and Asian women are overrepresented in the population of pregnant people in 2023. Meanwhile, Hispanic and “other” women were underrepresented.

Certainly, some decline in the number of pregnant people in prison could be expected, given that the national pregnancy rate in the United States has been steadily falling over the past two decades.⁵ However, this trend does not explain the dramatic reduction in the number of pregnant women in prison between the PIPS 2016 study and the Bureau of Justice Statistics’ 2023 report. Given the limited data available, we do not have any clear understanding of why there are so many fewer pregnant people reported in this Bureau of Justice Statistics publication.

First national data on pregnancy outcomes in prisons

This Bureau of Justice Statistics report is significant in that it offers the first national data on pregnancy outcomes in prisons — a welcome if overdue development. More than 700 pregnancies ended while the mother was in custody in 2023, and almost all of these were live births (91.5%),⁶ with 6.5% ending in miscarriage and 2.1% ending in abortion.⁷ Additionally, there were four stillbirths and ectopic pregnancies. These percentages are largely consistent with the outcomes of pregnancies reported in the Pregnancy in Prison Statistics (PIPS) study from 2016, however the counts are once again surprisingly low: in 2016, PIPS found 816 pregnancies ended in 22 state prison systems and the federal Bureau of Prisons, but in 2023, the Bureau of Justice Statistics reported 89 fewer pregnancies ending in prison (727 total) across the federal system and 48 state departments of correction.

Nationally, data on pregnancy outcomes regularly includes information about the outcomes of live births, including if they were preterm, early term, C-sections, or low birthweight, as well as if there was neonatal death (within 28 days) or maternal death following the birth. Although the U.S. Centers for Disease Control and Prevention regularly collects and publishes these data for non-incarcerated people, the Bureau of Justice Statistics survey did not request this information from correctional authorities, despite our recommendation during the public comment period. Basic national statistics on pregnancy in prison can and should include these outcomes. Elevated rates of chronic and infectious diseases – as well as substance use disorders – and limited access to necessary healthcare among incarcerated people make more detailed data about live births critical to understanding the experience of pregnancy in prison. Such data can also inform the interventions and medical treatments required to promote health before, during, and after birth for this population.

Some prisons fail to provide even the most basic prenatal and postnatal care

Pregnancy poses a number of short-term and long-term risks to health. Globally, the United States has one of the highest rates of pregnancy-related complications among developed nations,⁸ with a disproportionate burden falling upon women of color and low-income women.⁹ Addressing such risks is particularly important in prisons, where women already face higher rates of chronic health conditions, substance use disorders, and mental health conditions, as well as a history of poor healthcare access. Decarceration is the most important tool we have to address these risks, however as long as our society incarcerates pregnant people, prisons must be prepared and equipped to provide them with adequate healthcare and support before, during, and after delivery.

Most prison systems reported they train staff to care for pregnant people (88%) and have an onsite infirmary (96%) or 24/7 or on-call medical care (98%). The majority of prison systems also reported that they provide medical appointments to pregnant people within two weeks of a positive test (96%), routinely throughout the pregnancy (100%), and within three weeks of delivery (96%). Prison systems claimed that these services are available, however there is no information in the report about their actual utilization. Does every pregnant person have an appointment within two weeks of a positive pregnancy test and within three weeks of delivery? Do all staff receive training regarding pregnancy, or only healthcare staff? These questions are arguably more important than whether these services and practices technically exist.

It is particularly troubling that six state prison systems (Alaska, Hawaii, Iowa, Maine, Nevada, and Washington) reported that they do not provide any staff training regarding pregnant people in prison. No state prison system is immune from admitting a pregnant person, and these six states accounted for around 5% of the almost 50,000 women admitted to prison in 2021.¹⁰ At the very least, corrections and healthcare staff should receive training regarding emergency responses that may be required with a pregnancy.

Postpartum depression is another serious risk facing pregnant people. Nationally, postpartum depression diagnosis rates have been climbing: across all racial and ethnic groups, the rate of diagnosis increased from 9% in 2010 to 19% in 2021. Undoubtedly, this trend persists behind bars, where women face a number of risk-factors for postpartum depression. This includes previous mental illness diagnosis,¹¹ a lack of social support, poor prenatal and perinatal healthcare, separation from the newborn, and experiencing partner violence. In one study of 58 people who gave birth while in prison, researchers found that more than one-third of participants met the diagnostic criteria for moderate to severe depression during pregnancy or postpartum. Yet four state prison systems (Alabama, Iowa, Massachusetts, and Washington) said they do not provide depression screenings during pregnancy or postpartum. Not screening for depression at all during pregnancy and the postpartum period is a failure to meet the most basic standards of pregnancy-related care.

The Bureau of Justice Statistics report also provides information about which state prison systems provide certain accommodations and support services to people before and after delivery. Prison systems universally reported furnishing at least two accommodations for pregnant people: lower bunk placement¹² and prenatal vitamins.¹³ Most (but not all) prison systems offer a special diet during pregnancy (86%) and consultation with social workers (92%) or psychologists (88%). Prenatal diets require increased calories and a particular balance of nutrients that are likely not met by the typical prison diet. Accessible, appropriate mental health services for pregnant people behind bars are also vitally important, and most standards for pregnancy-related health care in correctional settings emphasize the need for counseling and psychosocial support.

Other extremely basic accommodations are less common in prison systems. These include a special postpartum diet (60%), doula support (35%),¹⁴ extra pillows during pregnancy (69%), and breast pumps (78%). These relatively simple interventions can have a tremendous impact during pregnancy and postpartum. For instance, the recommended postpartum diet is associated with fewer symptoms of postpartum depression and can positively impact infant health. People in prison are regularly issued only one pillow, but pregnant people may require more to be comfortable and avoid sleep deprivation, which has been associated with longer labor, elevated perception of pain and discomfort during labor, higher cesarean rates, preterm labor, and other adverse outcomes. While policies may be in place for breast pumping accommodations in most prison systems, the actual accessibility and utilization of breast pumps may be a different story. Some prison systems operate lactation programs that allow incarcerated people to pump breast milk for their babies. However, these programs often have onerous requirements for the incarcerated person’s friends and family, who have to apply for approval to visit and collect the milk. In Florida, for example, incarcerated people are only eligible for this program if there is an approved guardian for the child and the child is not placed in state custody. Reports suggest that when there is no lactation or pumping program, incarcerated people are sometimes not allowed to breastfeed after giving birth,¹⁵ and are not provided with anything to help manage an unused milk supply or information about what to expect.

It’s undoubtedly helpful to know which jurisdictions offer these services, but there is once again no information regarding their actual utilization. In 2016, self-reported data from incarcerated people revealed that half of people pregnant upon admission had not received prenatal care in the form of special testing, dietary changes, or childcare instruction. It’s great that prison systems have policies in place to provide these necessary services, but it is not clear at all how they are being implemented and how many pregnant people actually receive them.

Only 11 states and the federal system operate prison nursery programs where newborns can reside with their parents in custody

The Bureau of Justice Statistics reported that ten states and the federal Bureau of Prisons run prison nursery programs, which are residential programs where people can live with their newborns. Although reducing the incarceration of pregnant people is the best approach to this issue, prison nurseries can be another option that allows incarcerated mothers to avoid separation, and to be with and care for their newborn children. Since the data collection period ended for this report, an eleventh state — Missouri — opened their prison nursery program. Even though there were 665 live births in prisons across the U.S. in 2023, only 86 people were participating in prison nursery programs at the end of the year. In Nebraska and West Virginia, there were no nursery program participants at the end of the year.

There are a number of details about these prison nursery programs lacking in the Bureau of Justice Statistics report. For example, how many people participate in the programs each year and for how long? What programming is available to the participants while in the nursery program? How is eligibility determined for participating in these programs? Again, while data on the number of nurseries is helpful, it’s arguably more important to know how they are being used. So, to better understand how prison nursery programs actually work, we looked at the eligibility requirements and restrictions for prison nursery programs in 11 states and the federal Bureau of Prisons.

We found that in all but one of the prison nursery programs, participation requires release dates within 12 to 36 months of the expected delivery date.¹⁶ A number of factors can influence eligibility, including offense types, prison disciplinary history, medical or mental health status, prior Child Protective Services involvement, and prison security designation or classification. In Illinois, for example, any child that requires “more than normal well child health care” or any parent requiring “more than normal” prenatal or postnatal care can be excluded from the program. In California, Illinois, Indiana, Ohio, and West Virginia, the incarcerated mother must have sole legal custody of the child. To our knowledge, there are no data available about how often a child born to an incarcerated parent remains in their custody, but there is historical evidence to suggest that this is likely rare, or at the very least, complicated.

Eligibility requirements and considerations for prison nursery programs

Unfortunately, because the Bureau of Justice Statistics report does not include information on the sentence length, offense type, prior convictions, or classification status of pregnant people in prison, it is difficult to estimate how many pregnant people in prison would be eligible for these programs. These potentially beneficial programs are a vast improvement over the common practice of simply removing newborn children from their parent at birth.¹⁷ However, access to nurseries is still seriously limited, and ultimately, the best option would be to implement caregiver mitigation and diversion laws and prevent the incarceration of pregnant people.

Conclusion

This Bureau of Justice Statistics maternal healthcare report marks an important step toward filling the huge data gap regarding the incarceration of pregnant people in prisons. Given their particular healthcare needs and the challenges to a healthy pregnancy imposed by the prison environment, these data can help inform interventions that lead to better outcomes for incarcerated pregnant people. Although the data answer some of our initial questions about how many pregnant people enter prison and what jurisdictions have policies offering specific supports, significant questions remain. In addition to getting to the bottom of why the findings in the Pregnancy in Prison Statistics study differ so substantially from the Bureau of Justice Statistics survey, future researchers can make important contributions by answering questions such as:

1. What are the trends in pregnancy in prison over time? Why are these estimates of the prevalence of pregnancy in prison lower than prior estimates?
2. How many people actually receive the services that these jurisdictions report offering?
3. What barriers do prison systems face in providing the most basic prenatal and postnatal care, like depression screenings?
4. Why are so many pregnant people incarcerated (i.e, for what offenses) and for how long (i.e., sentence length)?
5. What are the outcomes of the live births counted in this report (i.e., preterm, early term, C-sections, low birthweight)? What are the rates of neonatal death and maternal death among this population?

Data on maternal healthcare and pregnancy outcomes should continue to be collected and published on a regular basis by the Bureau of Justice Statistics. Doing so — especially in greater detail — would shed light on an important and understudied healthcare experience in prison.

100 days of the Trump administration rolling back progress in the criminal legal system

Today, we released a new tracking tool that shows the full scale of the crisis unfolding in communities and behind bars, and a new resource page for folks looking to learn more about the repression and detention of undocumented immigrants.

by Mike Wessler, April 30, 2025

With the first 100 days of President Trump’s second term complete, today, we released a new tracker on our website that highlights the ways the administration is making the criminal legal system larger, harsher, and less effective. The new tool, which will be updated regularly, highlights the ways that the administration is eviscerating the rule of law, undermining solutions that reduce incarceration and improve community safety, encouraging the use of extreme sentences and harsh law enforcement tactics, making prisons and jails worse, and reducing transparency in the carceral system.

Actions from the administration have come so fast that it has been nearly impossible to keep track of them all. This new tool connects the dots on these actions to show that they’re not individual policy choices but instead part of a larger strategy that doubles down on the failed policies that created the nation’s mass incarceration crisis in the first place.

The tracker also explains that, while the federal government directly controls only a relatively small slice of the American carceral system, the administration is using its bully pulpit and control over federal spending to coerce state and local governments into expanding their criminal legal systems and making them even more brutal.

Additionally, today we released a new resource page on our website that focuses on the intersection of criminal and immigration law, often referred to as “crimmigration.” While we include immigration detention in our broad view of mass incarceration, it is not our primary area of expertise. For those looking to learn more about the crimmigration crisis, we have compiled resources from experts and organizations directly focused on immigration on this new page.

The new federal policy tracker is available at: https://www.prisonpolicy.org/federaltracker.html

The new crimmigration resource page is available at: https://www.prisonpolicy.org/blog/2025/04/30/crimmigration_resource_roundup/

This new tracker and resource page are just the first steps in our organization’s commitment to create tools, data, and resources for advocates, lawmakers, and journalists as they work to push back on this new crisis in America’s criminal legal system.

Crimmigration resource roundup: Where to find data and resources on the criminalization of immigrants

A list of valuable online resources from organizations and agencies focused on immigration detention.

by Prison Policy Initiative, April 30, 2025

The current presidential administration is hellbent on making life difficult, if not impossible, for immigrants in the United States. Following through on campaign promises of mass deportation, Donald Trump has directed Immigration and Customs Enforcement (ICE) agents to raid neighborhoods and workplaces or otherwise expedite the removal of hundreds of thousands of people² who are in the country under various programs. This is an escalation of the troubling, decades-long merger of criminal and immigration law, sometimes referred to as “crimmigration.“ The government’s treatment of immigrants as criminals — from policing and criminally prosecuting them to incarcerating them in oppressive detention centers — raises profound concerns about due process, constitutionality, and the humane treatment of people.

About 48,000 immigrants¹ are languishing in immigration detention centers, local jails, private prisons, and other facilities like hospitals and hotels. Tens of thousands more are in federal prisons and local jails, primarily for simply entering the country; thousands more are children, in shelters, awaiting permanent placement. Add to this the hundreds of people from Venezuela that the U.S. has now disappeared to a mega prison in El Salvador, arguing it has no duty to provide them due process, and no power or responsibility over what happens to them next.

These numbers provide only a glimpse at the complex web of immigration detention, but they’re important given the many false narratives and misinformation filling the airwaves. It’s more important than ever to know where timely, reliable data exist about immigration detention and advocacy efforts to end the unjust confinement and removal of people and families who enter the U.S.

While we include immigration detention in our broad view of mass incarceration, it is not our primary area of expertise. For those looking to learn more about the crimmigration crisis, we’ve compiled several resources from experts and organizations directly focused on immigration. These lists are far from exhaustive and resources listed in no particular order; if there are others you think we should know about, please get in touch via our contact form.

Information and statistics about immigrant detention and removal

• The Transactional Records Access Clearinghouse (TRAC) is an essential resource for immigration data and summary reports about trends in immigration detention. (It also offers data and analysis on other federal agencies and issues.)
• Freedom For Immigrants, an organization working to abolish immigration incarceration, maintains a detailed interactive map on immigration detention, with data points like ICE field offices, companies that contract with ICE, and deaths in ICE detention.
• The federal agency itself, Immigration and Customs Enforcement (ICE), maintains the following data, though it should be approached with a measure of “data skepticism”:
  • ICE’s Detention Statistics dataset is updated twice per month and contains detailed data about people in custody, where they’re confined, the number of people on electronic monitoring or other surveillance technologies,³
    and other metrics like length of stay and segregation. (Scroll down to the bottom of the linked page to find the download links for the most recent data and previous year-end reports.)
  • ICE’s Enforcement and Removal Operations (ERO) statistics dashboards present the agency’s arrest, detention, removal, and expulsion data in a more interactive format, and include information about country of citizenship, how many people had a criminal conviction or pending charges, and changes over time.
  • ICE publishes lists of both active and pending 287(g) partnerships — those state and local law enforcement agencies who voluntarily report the immigration status of people in their custody to ICE, and carry out other immigration functions on ICE’s behalf.

Immigration advocacy efforts (national-level)

• The National Immigrant Justice Center, which has been providing legal services, research, and advocacy for over 40 years, has a lot of information on its website for those interested in how immigration intersects with mass incarceration, legal representation, the LGBTQ+ community, and other topics.
• Similarly, the Immigrant Legal Resource Center, which engages in policy advocacy as well as training and support for legal advocates, has compiled a number of policy maps, explainers, toolkits, model policies, and other timely resources for advocates on its Immigration Enforcement webpage.
• Detention Watch Network has comprehensive overviews of immigration detention issues, from family detention to ineffective oversight and the laws, quotas, and financial incentives that keep immigration detention centers filled.
• United We Dream has an extensive library of resources ranging from guides and fact sheets to webinars and livestreams.
• The Black Alliance for Just Immigration has compiled all immigration-related executive actions from the Trump administration, with clear explanations of what they entail and how they may impact Black immigrant communities.
• The Pioneer Valley Workers Center, an organization of low-wage immigrant workers in western Massachusetts, has advice for those looking to set up a “rapid-response network” of volunteers and services that can provide immediate assistance during immigration crackdowns and workplace raids. Though originally published in 2018, this resource remains relevant today.

Analysis and commentary

• César Cuauhtémoc García Hernández is a writer, law professor, and fierce advocate for a just and functional system of immigration laws. In addition to authoring three books about crimmigration, he maintains a newsletter, Immigration Law Unhinged, which has been tracking the Trump administration’s actions.
• Syracuse Professor Austin Kocher also writes a helpful data-focused newsletter with insights about immigration data and policy, as well as tips for data literacy for people working with official immigration data published by ICE.
• John Washington is a journalist and author of The Case for Open Borders, which exposes the dangers and lost creative potential of closed national borders, and makes the case for drastically rethinking how we approach borders.
• A recent Truthout article details the embrace of increased immigration detention by jails and private prisons across the country.
• In These Times, a monthly news magazine focused on politics and the economy, has published an opinion piece on the current blitz on immigrants and others who merely express ideas counter to the current administration.
• Silky Shah is a longtime immigrant justice organizer and currently the Executive Director of Detention Watch Network. Her writing can be found in several media outlets, but her book Unbuild Walls is a thorough primer on the intertwined systems of immigration and incarceration.
• Debunking misinformation is just as helpful as putting out accurate information. The American Immigration Council has done just that, with a fact sheet amassing dozens of studies all showing plainly that there is no connection between immigration and crime.
• The Economic Policy Institute, a nonprofit, nonpartisan think tank, put out this helpful explainer on why immigration is beneficial to the U.S. economy, busting myths about how immigration impacts jobs, taxes, housing costs, and more.
• Migrant Insider provides regular coverage and analysis of immigration news with a special focus on happenings ‘inside the Beltway’ — i.e., in Congress, the executive branch, and more.
• Jess Pishko’s Posse Comitatus newsletter is an indispensable resource on sheriffs, who play a unique and important role in immigration enforcement. One recent article examines Florida as “ground zero” for Trump’s mass deportation agenda.

Resources for immigrants, journalists, attorneys, and educators

For immigrants, “Know your rights” resources are all over the internet. These are some we found to be the most valuable:

• United We Dream published a Preparedness Packet of essential documents and key legal information to keep in a safe place, in case of immigration emergencies.
• Muslims for Just Futures has a free double-sided poster print-out with guidance on how to handle an unexpected visit from immigration law enforcement.
• Freedom for Immigrants‘ Resources page contains contact information and answers to common questions about immigrant detention and legal assistance.
• The National Immigration Law Center has a library of FAQs, fact sheets, and one-pagers about immigration enforcement and the rapidly changing policies and executive orders impacting immigrant communities.

Journalists, attorneys, and educators may find these additional resources helpful:

• Freedom for Immigrants has specific resources for journalists covering these issues.
• The Immigrant Legal Resource Center is a treasure trove of resources for attorneys and legal advocates, offering legal trainings, practice manuals, technical assistance, and other educational materials, including timely, responsive guidance about new policies and practices. In addition to serving legal advocates, they publish resources for directly-impacted people and community advocates.
• The National Immigration Project trains thousands of attorneys each year to ensure high-quality legal representation for immigration. Their library of resources for attorneys includes practice advisories, quick guides, and summaries of relevant case law.
• For educators, we suggest checking out this robust toolkit from the Children Thrive Action Network, which features a wide range of resources for helping children and families facing deportation, preparing communities to respond to workplace raids, and educating the public and lawmakers about the impact of immigration enforcement on children.
• The Zinn Education Project offers educators several role play lessons to help students think critically about immigration, particularly in historical context.
• The National Education Association, the nation’s largest teachers’ union, “strongly encourages schools and school districts to adopt a Safe Zones policy that outlines what educators, and staff should do if ICE attempts to engage in immigration enforcement at school.” It offers a toolkit for creating these protections.

President Trump said, “home-growns are next.” Here’s our response.

President Trump’s recent comments about sending Americans to a Salvadoran prison mark a new, dark turn in the fight to end mass incarceration.

by Prison Policy Initiative, April 17, 2025

Standing in the Oval Office on Monday, just before members of the media were ushered into the room, President Trump said to President Bukele of El Salvador, “Home-growns are next. The home-growns. You gotta build about five more places. It’s not big enough.”

Those “home-growns” he’s talking about, they’re United States citizens. They’re you and me.

Those “five more places” he asked the Salvadoran dictator to build, they’re “prisons”¹ like the one where the Trump Administration has already sent hundreds of immigrants, many of whom were snatched off the streets and shipped off without due process. This includes Kilmar Armando Abrego Garcia, whom the Trump administration has refused to bring back to the United States, defying a unanimous order from the Supreme Court.

The actions of the Trump administration against immigrants in this country, many of whom were here legally, are an unconstitutional human rights violation. At Prison Policy Initiative, we know that we are not experts in the immigration system in the United States, and as such, have so far deferred to the amazing organizations, experts, and advocates leading the fight against these policies. Trump’s words make clear that a different approach is needed from us.

Our mission at Prison Policy Initiative is to provide facts, research, and data about the ways mass incarceration harms residents of the U.S. — and not just those behind bars.

After these comments, we’ve been asked by countless people to weigh in on the steadily increasing signs that Trump is working to deport and incarcerate U.S. citizens to El Salvador. However, the truth is that there are no facts or data to provide context for this situation.

American presidents have done some really heinous things, and while these injustices provide clues about what we can expect next, they are not exact parallels to the threat that every resident of the U.S. currently faces.

American and Salvadoran prisons have more in common than you think. They’re large, brutal, costly, and don’t make communities safer. They destroy the lives of the people ensnared in them and the lives of their families. Both countries incarcerate similar numbers of people per-capita and both of their prisons serve as a death sentence for many inside. It is important to note, though, that the American system has at least the guise of due process and legal standards for facilities — such as prison conditions, oversight, and transparency — while this Salvadoran facility does not. Sending U.S. residents to far-flung prisons without due process would be a dramatic escalation of our country’s already misguided policies.

Those three words — “home-growns are next’ — should send a chill down the spine of every person in the country.

We don’t know exactly what Trump and his subordinates are planning. He’s made clear that Attorney General Pam Bondi is exploring the legality of incarcerating American citizens in another country. All credible legal experts agree that doing so would be unconstitutional.

But as we’ve already seen, the Trump administration doesn’t see the Constitution as an impediment to its actions. So there is little doubt that once the administration recognizes it can’t find a legal rationale for deporting U.S. citizens, it will surely make one up out of thin air.

In his remarks, he indicated that he was talking about deporting “violent people.” Perhaps this is an attempt to assure people that his unconstitutional plan to deport American citizens won’t go too far. But the truth is, many so-called “violent” crimes don’t actually involve physical harm. In some states, even drug offenses are deemed a violent crime.

The simple fact is that law enforcement can spin nearly any criminal accusation to be a “violent” offense in the U.S. criminal legal system. There is little doubt that if given the chance, the administration would warp the definition of “violent crime” beyond its already sagging bounds.

Of course, some apologists will attempt to assure the American people that as long as they don’t commit a crime, they have nothing to be afraid of. But does anyone really doubt that Trump is planning to use the full force of law enforcement to go after those who displease or oppose him? For months, he has said he wants do just that. This would make it so any act he doesn’t like would put you at risk of deportation to a Salvadoran prison, without due process and the opportunity to defend yourself in a court of law.

You would think that a president convicted of multiple felony offenses, which he insists are politically motivated, would be more attuned to the risks of such political prosecutions. But you’d be wrong.

Those three chilling words — “home-growns are next” — signal a dark pivot for our country and a dramatic expansion of the already devastating criminal legal system.

For an organization that prides itself on its ability to use visualizations and clear language to make sense of the goings-on in the criminal legal system, we are, for perhaps the first time ever, left at a loss for what to say.

But just because we’re at a loss today, doesn’t mean we’re sitting on the sidelines. Over the coming weeks, months, and maybe even years, as this crisis unfolds, we’ll be here:

• When we can provide data and analysis, we’ll share them with you.
• When we can elevate the voices and actions of experts and organizations in areas that are outside of our expertise, we’ll point you to them.
• And when there are opportunities to take action, we’ll tell you about them and be by your side.

We don’t know what comes next, but we’re in this fight with you.

New national data help fill 20-year data gap: Offense data for people in local jails

Our analysis of Jail Data Initiative data offers the first detailed, national view of the criminal charges for which people are jailed since the Bureau of Justice Statistics’ 2002 survey. We look at the one-day jail population as well as bookings over a full year; ‘top’ charges versus all charges; and break down trends by sex, jail size, and region.

by Emily Widra, April 17, 2025

Millions of people are arrested and booked into jail every year, but existing national data offer very little information about the actual criminal charges for which they are detained. In fact, the most recent national offense data published by the government about people in jail is from 2002, so we worked with the Jail Data Initiative to fill that gap using the best, up-to-date nationally representative sample available.¹ We now have a new “snapshot” of people in jail, by offense, on a given day; new insights about how low-level offenses like misdemeanors and supervision violations impact “jail churn” over the course of a year; and we were able to analyze some variation in offenses by sex and, for the first time, by region and jail jurisdiction size.

One-third of annual jail admissions are for misdemeanor charges

The “massive misdemeanor system” in the U.S. is an important but overlooked contributor to overcriminalization and mass incarceration. An estimated 13 million misdemeanor charges – for behaviors as benign as jaywalking or sitting on a sidewalk – sweep droves of Americans into the criminal legal system each year (and that excludes civil violations and traffic offenses, like speeding).

The Jail Data Initiative data reveal that misdemeanor charges accounted for more than 2.7 million jail admissions (35%) in 2023. This is a much higher percentage than the Bureau of Justice Statistics’ snapshot of the jail population on a single day in 2023 shows: the Bureau reports that only 20% of people in jail were held for misdemeanor offenses.⁵ The difference is explained by “length of stay” or how long people are held in jail for different kinds of offenses. People charged with felony offenses show up disproportionately in single-day snapshots because they spend more time in jail than those facing misdemeanor charges.⁶ Longer jail stays associated with felony charges are due in part to higher bail amounts for felony offenses.⁷ Because of these differences, single-day snapshots make it easier to overlook just how many people are jailed for low-level, misdemeanor offenses each year.

Misdemeanor charges may sound trivial, but they carry serious financial, personal, and social costs, especially for the accused but also for broader society, which finances the processing of these court cases and all of the unnecessary incarceration that comes with them. Pretrial detention actually makes people charged with misdemeanors more likely to plead guilty, to be sentenced to incarceration, and to receive longer jail sentences. Rather than investing in community-driven safety initiatives, cities and counties are still pouring vast amounts of public resources into the processing and punishment of these minor offenses.

Many people are jailed for “technical violations” of community supervision, not new criminal charges

Probation and parole are often seen as a “lenient” punishment or as an ideal “alternative” to incarceration. But while remaining in the community is generally preferable to being locked up, the conditions⁸ imposed on those under supervision are often so restrictive that they set people up to fail.⁹ “Technical violations” are behaviors that break these probation or parole rules, such as missing curfew, failing a drug test, or missing a check-in meeting; they are not behaviors that would count as “crimes” for someone not under community supervision. However, when people who are under community supervision are charged with a new crime, that also constitutes a violation of their probation or parole, and typically must be reported. Individuals can often be kept in jail without bail for either type of violation on a probation or parole detainer.

In 2023, there were about 7.6 million jail bookings, and the new Jail Data Initiative data indicate that almost 926,000 of those bookings (12% or 1 in 8) involved an alleged probation or parole violation. Almost a half million (484,000) people jailed in 2023 were jailed only for technical violations of community supervision and faced no additional criminal charges.¹⁰ We did not find much variation between men and women related to bookings for violations; 11% of women and 13% of men were booked into jail with probation or parole violations and about 7% of both women and men booked into jail were jailed for only technical violations.

Looking at a single-day snapshot, we see that about 19% of people in jail on a single day in June 2024 had probation or parole violations. This is comparable to what the Bureau of Justice Statistics found in 2023.¹¹¹² Our single-day snapshot also showed that women were more likely to be stuck in jail for a technical violation: 9% of women in jail had been admitted with only a charge of a violation, compared to 6% of men. To square this with the findings of only minimal sex differences in the year-long booking data, recall that “length of stay” impacts who is likely to be sitting in jail on a given day. Since women held on unaffordable bail typically have very low incomes, it’s plausible that women spend more time in jail for violations because they are less able to afford the bail money, when they are eligible for bail at all.

The first detailed national jail offense data published in two decades

Given that the most recent jail offense data is over 20 years old,¹³ the Jail Data Initiative dataset offers a rare opportunity to analyze the charges that people are booked under today. Our partners at JDI standardized the listed charges into both broad offense types (violent, property, public order, drug, DUI offense, and criminal traffic) and more specific charge types like aggravated assault, burglary, liquor law violations, drug possession, driving while intoxicated, and minor traffic offenses.¹⁴ Additionally, unlike the Bureau of Justice Statistics 2002 data, the JDI dataset allows us to look at all the charges individuals are booked under, in addition to the “top” – or most serious – charge for each person.

People frequently face multiple charges when they are booked into jail

People booked into jail often face more than just one criminal charge: in our sample, there were an average of four separate charges per person.¹⁵ When we look at all charges for each booking rather than “top” (most serious) charges, we find that the most frequently-used charges are often not the same as the most common top charges. People in jail often face “stacked” charges, where additional charges are added on to the most severe charge. Nine of the top 10 most common charges are relatively low-level offenses that don’t involve physical violence, including failure to appear in court, forgery or fraud, contempt of court, and drug offenses (the only serious violent offense in the top 10 most common charges is aggravated assault).¹⁶

In addition, some charges are more likely to be levied “in bulk” (e.g., people will often be detained on many counts of forgery/fraud) and this may also explain why we see charges like forgery/fraud in the top 10 most common charges. Regardless of the severity of the charges, people facing more charges face higher bail amounts, are more likely to be jailed for longer periods of time, and are more likely to be convicted.

Offense data by most serious charge per person: Most people are jailed for non-violent offenses

Looking at just the “top,” or most serious, charge facing each person in jail on a given day in 2024, we find that almost two-thirds (about 415,000) are facing a top charge that is not considered a violent offense.¹⁷ About 23% of people are jailed for a most serious charge that is a public order offense, 21% for a property offense, 14% for a drug offense, and 4% for a driving under the influence (DUI) or criminal traffic offense.

The number of people in jail for charges that reflect little-to-no risk to public safety is alarming: 8% of people were in jail with a top charge of a supervision violation, 7% for drug possession, 5% for offenses against courts, legislatures, and commissions,¹⁸ and 3% for contempt of court¹⁹ – these four kinds of charges alone account for almost a quarter of the total jail population. Probation and parole violations are the second-most common top charge, following aggravated assault. We’ve long argued that noncriminal behaviors (like missed check-ins or nonpayment of fees) should not lead to incarceration — this strips people on community supervision of any progress they’ve made, further destabilizes them and their families, and is a thoughtless waste of public funds. Each state approaches supervision violations differently, but some rely on incarceration as a response more than others. For example, 2019 data from the Bureau of Justice Statistics show:

• Tennessee’s jails hold 9,280 people for an alleged violation of supervision, accounting for 30% of the total jail population;
• In both Georgia and West Virginia, over 15,000 people — 28% of the jail population — are behind bars for supervision violations;
• An alarming 39% of the jail population in Ohio is composed of people accused of violating the rules of their supervision.

Probation and parole officials can use more effective alternative sanctions and approaches, such as incentive-based systems, but clearly too many continue to default to a “lock ‘em up” response.

Three in four women in jail are facing non-violent charges

More than 90,000 women are locked up in local jails on any given day in the U.S., representing about one-seventh of the entire jail population (14%). The new data from the Jail Data Initiative reveal that three-quarters (75%) of these women have non-violent top charges: 28% public order, 25% violent, 25% property, 19% drug, 2% DUI, and 2% criminal traffic. Further, a smaller share of jailed women (25%) than jailed men (38%) are facing a top charge that is considered violent. Compared to the 2002 Bureau of Justice Statistics data, public order and violent charges account for a larger portion of the top charges women face in 2024, while a smaller portion of women in jail are facing drug charges (-10 percentage points) and property charges (-7 percentage points).²⁰

Over a three-year period from 2020-2023, the number of women jailed at midyear increased 36%, compared to 19% for men. Women are disproportionately locked up in local jails, because they are less likely to be able to afford money bail required for pretrial release, and if convicted, they are more likely to serve a shorter sentence for a property or drug offense in jail than go to prison. While there, women in jail experience bleak conditions like expensive phone calls, a lack of programming and education opportunities, and poor quality healthcare.

In addition, the jailing of women has a devastating “ripple effect” on families and communities: at least 80% of women booked into jail are mothers, including over 55,000 women who are pregnant when they are admitted.²¹ Beyond having to leave their children in someone else’s care, these women are impacted by the brutal side effects of going to jail: aggravation of mental health problems, a greater risk of suicide, and a much higher likelihood of ending up unhoused or deprived of essential support and benefits.

Regional variations in criminal charge distributions reflect differing priorities across states

Breaking down the data by region (i.e., Northeast, Midwest, South, and West) allows us to assess how different parts of the country use jails.²² For example, previous research shows that jails in the Midwest and West have the highest percentages of people detained pretrial, while jails in the South have the highest percentages of people being held in jails for state, federal, and tribal authorities (20%).²³

We find that regionally, jurisdictions respond to certain types of offenses differently. For example, only 8% of people in jails in the Northeast are held for a top charge related to drugs, but in the South, 16% of people are held for drug charges, suggesting that a significant regional difference in the criminalization of drug use influences who is locked up. In addition, the Northeast is the only region to have weapons offenses and rape among the most common top charges, while the West is the only region with DUIs among the most common top charges. It’s important to note that these variations don’t necessarily reflect differences in actual crime rates across regions, but rather the kinds of charges law enforcement and courts in those areas deem appropriate for jail detention.²⁴

Drug possession is among the top 10 most common top charges for all regions except the Northeast.²⁵ It’s worth noting that drug and drug paraphernalia²⁶ possession offenses have been reduced to misdemeanors only – or decriminalized in part or in full – in a larger portion of Northeastern states than in any other region. Half of the Northeastern states have decriminalized drug paraphernalia, and in the remaining half of Northeastern states, possession of drug paraphernalia is limited to a misdemeanor. Only three Northeastern states (33%) classify drug possession as a felony offense, while other regions more commonly classify drug possession as a felony offense (83% of states in the Midwest, 69% in the South, and 46% in the West).

Laws and policies are largely set at the state level, so further investigation of state-level differences in charge distributions would help policymakers understand how their decisions impact jail populations, in places where the data are available. (In the sample used in this analysis, state-level comparisons were not possible.)

Smaller jails disproportionately incarcerate people for low-level offenses

Differences between jails in larger and smaller counties have grown more pronounced in recent years: as jail incarceration in large, urban counties has decreased in a number of jurisdictions, jail incarceration has exploded in smaller jurisdictions – including rural counties and those with small towns and cities.²⁷ While the Jail Data Initiative data are not broken down by rural vs. urban areas, we used jail size as a proxy measure to explore the differences in the charges smaller vs. larger jurisdictions are using their jails for.

We find that smaller jails – typically in jurisdictions with smaller overall populations – tend to have a larger portion of people incarcerated for public order and drug offenses, while larger jails hold people primarily for violent offenses. While we can’t identify the causes behind these differences from this dataset, this difference is likely explained – in part – by higher rates of violent crime in metropolitan areas.²⁸ Jails in these more populous jurisdictions are more likely to use their available beds for these more serious offenses, while smaller jurisdictions may have more space available to fill with people accused of low-level offenses. For example, charges of rape and armed robbery only appear in the ten most common top charges in jails holding 1,000 or more people (the largest jails). In the smallest jails that hold 250 people or less, 9% of people jailed are held for supervision violations, compared to 5% in jails holding 1,000 or more. Similarly, 8% of people in those smaller jails are held for “offenses against the court,” compared to 3% in the largest jails.

Conclusion

The importance of local jails to the full picture of mass incarceration cannot be overstated. Jails hold one-third of all people locked up in the U.S., most of them not convicted of the charges they are facing and detained because they cannot afford bail. Pretrial detention is the primary driver of jail population growth: over the last twenty years, the number of unconvicted people in jail increased by 34%.²⁹ Our findings come amidst a trend of small, less-populous counties (along with some larger urban counties) continuing to build new and bigger jails. This analysis shows that these costly projects, far from being a public safety necessity, are likely to exacerbate the jailing of poor people for minor offenses—while taking away resources from investments that make communities safer, such as affordable housing and healthcare.

Our analysis highlighting trends in jail detention across the country would not be possible without the data collected by the Jail Data Initiative. JDI offers one of the only alternative sources of information about why hundreds of thousands of people are behind bars, given that the Bureau of Justice Statistics has not released updated offense information for jail populations nationwide in over twenty years. This invaluable data source enables even more comprehensive analysis by capturing and standardizing individual-level booking data from hundreds of jurisdictions, offering a unique view of the flow of people through local jails over time, in addition to a detailed, updated “snapshot” view.

Rolling back solitary confinement reforms won’t make prisons safer

Thousands of New York prison guards went on strike to demand changes to the HALT Solitary Confinement Act. They claim limitations on solitary confinement have worsened working conditions. Here’s why the decision to return long-term isolation to New York’s prisons won’t fix things.

by Emmett Sanders, April 11, 2025

While the international community has long recognized solitary confinement as a form of torture, in the United States, the practice is as ubiquitous as the prison system itself. A 2023 report from Solitary Watch noted that on any given day more than 80,000 people in U.S. prisons are held in solitary confinement. People may spend months or even years in isolation, with devastating results. The HALT Solitary Confinement Act (HALT), passed in 2022 and advanced by the New York Campaign for Alternatives to Isolated Confinement (many of whom are themselves survivors of solitary confinement), was intended to change this for people in New York’s prisons. While this legislation did not eliminate the use of solitary confinement altogether, it made important changes like limiting stays to 15 days at a time, initiating review practices, and providing protections for vulnerable populations like the elderly, pregnant people, and those with mental or physical disabilities. However, as in many places that have attempted solitary confinement reform, these efforts have been met with resistance.

In February, correctional officers across the state of New York began a “wildcat” strike, an unsanctioned work stoppage in violation of New York law. For 22 days, around 15,000 correctional staff across 42 prisons refused to work, forcing Governor Kathy Hochul to call in the National Guard as a stopgap measure. As might be expected, incarcerated people bore the brunt of harm of the strike; at least seven incarcerated people died during the strike. There were also reports of insufficient medical care, dangerously filthy living conditions, and the interruption of programming and visitation. Striking corrections officers’ representatives claim the strike was a desperate response to deteriorating working conditions and understaffing, much of which they blame on HALT.

Ultimately, Hochul gave in to strikers’ demands to rescind HALT protections, first temporarily suspending them, then later agreeing to extend this suspension pending further evaluation,¹ a move that illegally sidesteps the legislative process.² The rollback of HALT protections leaves people in prison once more subject to extended isolation in solitary confinement. It will also do little to improve working conditions or to fix staffing concerns and stands to make prisons even less safe.

Unpacking the claim that solitary reforms have compromised safety

Strikers’ claims that the HALT Act’s restrictions have hamstrung correctional officers’ ability to maintain order is dubious at best. This is largely because many prisons have simply ignored HALT provisions, routinely violated the law, and have continued to use solitary confinement in much the same manner as before. New York’s Office of the Inspector General, as well as a June 2024 court ruling found that:

• 40% of people were held in solitary confinement longer than the law allowed;
• 24% of the time, people were held without sufficient evidence of a segregable offense;
• People were routinely held hundreds of days past the 15-day time limit without sufficient review;
• People with disabilities have also continued to be thrown in solitary; and
• The head of the prison system even issued a blanket order to use restraints for all out-of-cell activities, in direct violation of the law.

Correctional officers’ claim that a tool has been taken out of their toolbox is disingenuous when that tool is still being used every day, and in much the same way it was before the law changed. Simply put, you cannot attribute a rise in violence to a change in policy when you have refused to implement that policy.

Dubious statistics around rising staff assaults

Reports do show rising numbers of assaults on staff as well as on incarcerated people. However, this rise predates the implementation of the HALT Act by several years. Between 2012 and 2014 the number of assaults on staff nearly doubled. In fact, both the number of staff assaults and the rate of staff assaults per incarcerated person have risen every single year since 2016. Thankfully, the vast majority of incidents result in “no injury” at all to correctional staff staff and most others result in “minor injuries” that “require no or minimal treatment.”³ It is also worth noting, like the department of corrections itself does, the distinction between assaults as defined by penal law, “which require physical harm,” and assaults as defined by department policy; according to its policy, “events where no physical injury occurs and events where any object, including a small object, is thrown at and hits another person” can result in assault reports. While this current spike is concerning and should be investigated, formerly incarcerated advocates also point to a history of correctional staff falsifying reports and weaponizing the disciplinary process to cover up a culture of abuse. One formerly incarcerated survivor of abuse at the hands of correctional officers noted, “They control the statistics.“

Skepticism also surrounds the timing of the strike, which comes just as the department faces public outcry after correctional staff accidentally videotaped themselves beating an incarcerated man, 43 year-old Robert Brooks, to death in December. More than a dozen correctional staff were indicted in the case on February 20th, which drew national attention. Critics point to previous work stoppages which coincided with allegations of abuse and increased scrutiny.

Claims that changes in the use of solitary confinement are responsible for a massive staffing shortage in New York Prisons also bear closer scrutiny. Most jails and prisons across the country have not implemented reforms to solitary confinement, but have seen similar recent reductions in staffing levels. While physically and mentally hazardous working conditions are certainly a contributing factor, they are far from the only reason. In fact, in a recent survey by Corrections Today, the top three reasons people reported leaving corrections were work-life balance, pay, and a lack of flexibility in schedule. Safety concerns ranked 8th on the list of 15.

Prisons are not understaffed, people are over-incarcerated

Moreover, prisons are not understaffed, but rather people are over-incarcerated. In New York, much of the problem lies in the fact that despite massive reductions in the prison population that have far outpaced reductions in staff, correctional officers and politicians alike have actively opposed efforts to decarcerate. While New York has managed to close a number of prisons since 2011, saving taxpayers more than $492 million, these efforts have been met with resistance and, at times, resignations from correctional staff. They persist in fighting to keep prisons open, even when they are two-thirds empty, when these facilities could be closed and their resources reallocated. Their argument is that closing prisons will bring economic collapse to small towns. These claims underscore that incarceration is indeed an industry in which the primary end-product is human misery. They are also patently untrue; prisons actually weaken rural economies.

A closer look at the numbers shows how problematic this insistence on keeping unnecessary prisons open actually is. Since 2003, the number of prison staff has fallen by just over 32%. However, New York’s prison population has fallen by more than 49% over that same period of time. Indeed, while prison staff dropped around 6% between 2020 and 2021, the incarcerated population dropped nearly 11% that same year and had fallen 22% the year before.

Perhaps most interestingly, the ratio of correctional staff to incarcerated persons stood at 1:2.4, or around one staff member for every 2 to 3 people incarcerated in New York prisons. This ratio is actually better than in 2018. In fact, the most recent national data show that New York prisons have the best staff-to-incarcerated person ratio in the nation. However, this is undercut by maintaining prisons that are far below capacity, largely because of, as the Department of Corrections notes, “the security needs that exist in the facilities regardless of the incarcerated individual population.”

Solitary confinement doesn’t prevent harm, it creates it

Counter to strikers’ claims that the use of solitary confinement is necessary to maintain safety, isolating people who often already have mental health support needs in prison conditions that impair emotional, social, and cognitive function does not make anyone safer. Solitary confinement doesn’t reduce prison violence, nor does it make people rush to fill out applications for prison jobs and make prisons better staffed. What is does do is create lasting harm that shortens people’s lives, devastates their mental and physical health, has been associated with heightened risk of suicide and self-mutilation, and further entrenches racial and gender disparities in the prison system. Even worse, perhaps, solitary confinement has actually been shown to diminish public safety by increasing the chances of a return to prison after people come home. Research has repeatedly shown that reducing the use of solitary confinement significantly reduces prison violence.

Ultimately, the crisis in New York prisons is one of an ongoing commitment to brutality rather than a crisis of capacity, and it is not one that will be resolved by doubling down on state-sanctioned torture and abuse. If New York wants to resolve the capacity issues that strikers claimed were at the heart of their protest, the state needs to address the real issues, rather than attack a humane reform that has never fully been implemented. HALT’s provisions should be fully reinstated, and, as incarcerated journalist Eric Williams rightfully points out, the state should implement legislation, and common-sense policies that can safely and cost-effectively further reduce New York’s prison population. Most importantly, the state should continue to close unnecessary prisons and fund new forms of economic development in these rural communities that don’t rely upon the narrative that incarcerated people are, as one New York legislator has claimed, “the animals of society.“ They are not. They are family members and loved ones. They are human beings, and they should not be subjected to torture.

Seven facts about mass incarceration that sound like April Fools’ Day hoaxes, but aren’t

Fines for suicide attempts, prisons built near toxic wastelands, the overwhelming number of people in the system…it's hard to believe, but it's true.

by Wanda Bertram, April 1, 2025

We at the Prison Policy Initiative are in the business of making America’s draconian, exploitative, sprawling incarceration system more obvious to everyone. The basic facts of mass incarceration are easy to grasp when laid out in, say, a pie chart. But there are other elements of the criminal legal system that never stop boggling the mind — even for us.

For April Fools’ Day, here are seven facts about incarceration and supervision that are as hard to believe as they are hard on people in the system:

Prisons and jails maintain “welfare funds” that are supposed to benefit incarcerated people, but often use the money to shore up their budgets or spend it on treats for themselves.

When incarcerated people and their loved ones pay for phone calls or commissary goods, it creates revenue for companies, which kick back some of the money to the facilities themselves. This money is funneled into “inmate welfare funds.” But what happens to it then? In our report Shadow Budgets, we revealed that prisons and jails often use the funds not for special purchases on behalf of incarcerated people, but to shore up their own operating budgets — or even to pay for perks for themselves.

In one county — Dauphin County, Pennsylvania — the local paper exposed the jail using its welfare fund for purchases as inappropriate as fitness trackers and gun range memberships for staff.

For more, see the original story from PennLive.

One-third of state and federal prisons sit within three miles of federal Superfund sites.

Research warns against living, working, or going to school near Superfund sites — the most toxic places in the country — as this proximity is linked to lower life expectancy and a litany of terrible illnesses. But many incarcerated people have no choice. With many prisons located near toxic wastelands, people in prison all too often develop health problems: For instance, in western Pennsylvania, a state prison located on top of a coal waste deposit has led to skin rashes, sores, cysts, gastrointestinal problems, and cancer.

The average yearly income of someone in jail pretrial is less than $20,000.

Nearly half a million people are sitting in a local jail awaiting trial. Their average yearly income hovers just under $20,000, meaning that it’s easy to keep them locked up by imposing cash bail (the median bail amount for people detained on bail who are accused of felonies is $25,000). Women and Black people in jail have even lower incomes on average, making them even more vulnerable to being stuck in pretrial detention, which can very quickly lead to losing one’s job, losing custody of children, forgoing medical appointments, and so on. And pretrial detention doesn’t just throw someone’s life into chaos — it makes it more likely that they will plead guilty just to get out of jail.

Felony convictions may not disqualify someone from being president, but they still block people from jobs like bartending, car sales, and pest control.

19 million people in America have felony records. And occupational licensing requirements, the standards and rules that govern who can work in certain professions, often explicitly exclude anyone with any felony conviction. These rules thus lock millions of people out of jobs like nursing, sales, bartending, and firefighting, no matter the details of their conviction — making it much more likely that formerly incarcerated people will end up in low-paying, itinerant jobs rather than stable employment.

You can’t help but ask: If someone with a felony conviction isn’t barred from becoming president, why should they be barred from all of these positions that have far less power and responsibility?

Many of the 2.9 million people on probation have to take regular drug tests — which they often must pay for — even those whose convictions have nothing to do with drugs.

In our report One Size Fits None, we combed through probation rules in 76 jurisdictions and found that 62% of those places require all people on probation to submit to regular drug tests. Not only is drug testing dubiously effective in advancing any public safety goals; the rules mean that even if someone’s conviction had nothing to do with drugs, they have to get tested anyway. Worse, many of these jurisdictions make people on probation pay for their own tests, at a cost of between $15 and $20 per test (often multiple times a week).

Several state prison systems slap financial sanctions on people who attempt suicide or harm themselves.

Not only do most prisons coerce incarcerated people to pay copays to see a doctor; some actually make people pay the prison back for costs incurred through acts of self-harm. Iowa, Georgia, Nevada, and New Mexico’s policies on disciplinary fines state that incarcerated people can be made to reimburse the state if they attempt suicide or hurt themselves in prison, an environment known to aggravate mental illness. In Virginia, corrections staff recently discussed financially penalizing people who self-immolated in protest last year.

Nearly half of all Americans have an immediate family member who has been incarcerated.

FWD.us reports that 113 million adults, or 45% of all adults in America, have had an immediate family member locked up for at least one night. These figures underscore that while having a criminal record — or even having an incarcerated loved one — carries heavy stigma in this country, it is an incredibly common experience. Making the criminal legal system fair and just is not something that impacts a select few; it’s directly relevant to our friends and neighbors.

And 10 things you shouldn’t believe

While these facts about incarceration are hard to believe but unfortunately true, there are also a number of myths floating around about the criminal legal system. Head over to our recent report Mass Incarceration: The Whole Pie 2025 where we bust 10 common myths about incarceration the far too many people do believe. We cover the exaggerated impact of private prisons, phantom “factories behind fences,” the crime waves that weren’t, and more.