Policy Implications of Repealing the IMD Exclusion

Executive Summary

Federal and state policymakers are urging a repeal of a provision of the Medicaid Act that encourages states to invest in community-based health care services. Specifically Medicaid law currently bars federal financial support for inpatient beds at institutions (so-called Institutions for Mental Diseases or “IMDs”) that have a long history of providing inadequate and even draconian care for people seeking treatment for behavioral health services. National Health Law Program Senior Attorney Jennifer Lav explains in this issue brief that lawmakers have other options for bolstering mental health care and substance use disorder care without reverting to funneling money back into institutions, and away from community-based care. Lav lays out “eight concrete steps federal and state governments can take to expand access to treatment through Medicaid that do not necessitate repealing the IMD exclusion.”