Government-sanctioned discrimination against impoverished mentally ill adults – and minority adults in particular – was detailed today at a Congressional briefing on Medicaid's IMD exclusion. The briefing was hosted by the Treatment Advocacy Center at the invitation of Representative Eddie Bernice Johnson (D-Texas).
“In addition to all the other forms of discrimination people with mental illness suffer, coverage of their psychiatric treatment in all but the smallest dedicated facilities is banned by federal law,” said Doris A. Fuller, Treatment Advocacy Center executive director and moderator of the briefing. “If these critically ill individuals needed inpatient or long-term care for heart disease or diabetes or dementia: Medicaid would cover their care. But because they are mentally ill, it does not."
Representatives Eddie Bernice Johnson and Tim Murphy (R-Pennsylvania), along with the Congressional Homelessness Caucus, co-hosted the briefing.
“Medicaid is the only way that many low-income minorities can get healthcare, said Rep. Eddie Bernice Johnson. "But the IMD exclusion creates a barrier to psychiatric treatment for those who need it the most." said Eddie Bernice Johnson.
We allow millions to suffer because of broken commitment standards and a failed Medicaid policy," said Rep. Murphy. "To fix this problem and help the millions who end up on the streets or in jail because of a mental illness, we must pass the Helping Families in Mental Health Crisis Act."
The ban on Medicaid reimbursement for adults with mental illness was enacted by Congress in 1965 to motivate states to close large mental health institutions. More than 90% of the nation’s public psychiatric beds have since been eliminated, resulting in a shift of individuals with the most severe mental illnesses from residential treatment settings to jails, prisons, emergency rooms and the streets.
“It is not rational, humane or cost-effective to deny Medicaid coverage for medically necessary treatment to a specific population of poor people with mental illness, a practice that falls disproportionately on minorities living below the poverty line,” Fuller testified.
Rep. Johnson has led the fight to repeal the IMD exclusion, introducing legislation to fix the problem in the last four Congresses.
The Congressional briefing was the culmination of a series of public awareness events by the Treatment Advocacy Center National Minority Mental Health Awareness month.