The initiative was enhanced with the launch of the Institutional Relationship System (SRI), designed to speed up the progress of claims and standardize care.

As governor, he privatized the state owned supermarket, approved a pension reform, implemented public–private partnerships for education and health and supported electoral alliances with the PSDB and Democrats, center right historical rivals of PT, in the 2022 presidential election in order to defeat Bolsonaro.

[8][9][10][11] Following the 2015 killing of 12 men, including four teenagers, by state police,[12] Amnesty International published a Huffington Post article on its website, reporting that official figures from the Annual Report of Public Security, reveal that, each day, "at least six people are killed by police officers in Brazil" and that the true number is likely higher, as "most states across the country prefer to keep these alarming figures under wraps."

Costa was widely criticized for his public response, including a false narrative of events and declaring the police as "heroes".

[13] The ill-conceived comparison of a mass killing with an adrenaline-pumping football match is a sad illustration of the public security problems still experienced in Brazil – where mostly poor, young black men pay the price for the actions of a violent, militarized and poorly trained police force that has gone unchecked for far too long.Al-Jazeera also reported the killings and that the largest Black population in Brazil, resides in Costa's home, the Bahia state capitol, Salvador da Bahia, and that "80 percent of those killed by police in Brazil are young, black and poor.