NHeLP Comments on Idaho Behavioral Health Transformation Section 1115 Medicaid Waiver Demonstration Application

Executive Summary

In comments to the Department of Health and Human Services, the National Health Law Program urges HHS to reject Idaho’s proposed request to waive the Institutions for Mental Diseases (IMD) exclusion. HHS does not have authority to grant the request to waive the IMD exclusion because Idaho has not proposed a genuine experiment, and the Secretary may only waive requirements of the federal Medicaid Act to conduct an experiment or test a novel approach to improve medical assistance for low-income individuals. Furthermore, Section 1115 only permits waiver of those requirements found in 42 U.S.C. § 1396a, and the IMD exclusion lies outside of 42 U.S.C. § 1396a. Last, the proposal risks diverting funds away from appropriate community-based services, undermining decades of progress towards increased community-integration.