End IMD Exclusion

Repeal the Medicaid IMD Exclusion

Help end discrimination against life-saving mental health treatment.

What if we told you that there was a Medicaid policy that expressly forbade some psychiatric treatment facilities -- those with more than 16 beds -- from being reimbursed for providing life-saving medical care to people with serious mental illnesses or addictions that are between 22 and 64 years of age?

That sounds counter-productive, does it not? And discriminatory too, right?

Well, that policy, a relic of the failed move to deinstitutionalize psychiatric care in the last century, exists. It is named after so-called Institutions for Mental Diseases (IMDs), and policy wonks call it the IMD Exclusion.

Despite a nationwide shortage of psychiatric treatment beds that has reached crisis proportions, the IMD exclusion stands in the way of facilities providing desperately-needed care, making it illegal for facilities to receive federal reimbursement for treating Medicaid recipients with serious mental illnesses. Left untreated and with nowhere to go, too often these people instead turn to the streets, wind up in jails, or become statistics in the rising suicide epidemic. Enough.

Leading politicians from both parties understand the problem. For example, a leading Democratic U.S. Senator called the IMD exclusion “a policy that makes it extremely difficult for states to provide inpatient care to those with mental illness and substance use disorders.” And the chair of the President’s Commission on Combating Drug Addiction and the Opioid Crisis, a Republican, called it “old-fashioned, antiquated and ridiculous.”

In addition, a Washington Post analysis said repealing the IMD exclusion would be “a quick and simple way President Trump could immediately help Americans;” a "no-brainer," said the headline!

The Interdepartmental Serious Mental Illness Coordinating Committee, a federal panel of experts and administration officials, also recommends repealing the IMD Exclusion.

So what are we waiting for?

The time has come to repair our broken system. We just need to rally the political will to get it done. Together, we can.