Psychiatric Services

Medicaid’s Institutions for Mental Diseases (IMD) Exclusion Rule: A Policy Debate — Argument to Repeal the IMD Rule

It is widely acknowledged that the U.S. mental health care system is fragmented and uncoupled from the larger health care enterprise, owing, in part, to severe resource constraints, payment carve outs, and the long-standing systemic stigma that pushes individuals with mental illness and addiction into the shadows of society. Legislation that mandates insurance parity has helped to right decades of injustice. But beyond disparity in insurance coverage, more fundamental inequalities are at work. Conceptual disparity between physical and mental illness—the view that mental illness should be treated as separate from and unequal to physical illness—remains embedded in many health care policies.