Repeal the Medicaid Institutes for Mental Diseases (IMD) Exclusion

Long-term care should be accessible for everyone, no matter what the illness is called or where in the body the illness originates. End Discrimination against people with severe mental illness.

That all people should receive the same coverage for all physiological illnesses seems a given in this day and age of Mental Health Insurance Parity. However, one group of people, those with severe mental illnesses, seems to have been left out in the cold, once again. These are the "sickest of the sick", those so debilitated from their illness that they neither understand that they are sick nor how to seek treatment. This is required in the community mental health system we have today.

Like other illnesses, some people with severe mental illness do not recover. This is unfortunate but true. However, someone with a debilitating lung disease can gain access to a long-term care facility, and if they qualify due to their income, Medicaid will pay for it. This is not true for someone with Schizophrenia. This is because of the Medicaid Institutes for Mental Diseases (IMD) Exclusion; a law that has been on the books since Medicaid was enacted.

As a result, people with chronic, treatment-resistant, severe mental illness are homeless and incarcerated, numbering in the hundreds of thousands. For some, it meant death. Not only does this law discriminate against people with severe mental illness, the effects are devastating in the order of constituting a human rights violation.

The Health Care Reform bill that has just passed contains a partial repeal of the IMD Exclusion, but does not allow for the payment of long-term care. Why?

The IMD Exclusion should be repealed in its entirety. Picture this: Someone who had diabetes was in a long-term care facility that only treated people with diabetes, and a law was passed that Medicaid would no longer cover those facilities. No other facility would accept that patients for fear of losing their Medicaid coverage for all of their patients. This wouldn't be tolerated by anyone, would it? So why do we accept this type of discrimination against people with mental illness? There is no good reason why.

Please support H.R. 619, introduced last year by Representative Edie Bernice Johnson (TX-30). This is the only way this discrimination can be ended.