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Washington, D.C. – This week, Rep. Tom Emmer (MN-06) sent a letter to Speaker Nancy Pelosi and Majority Leader Mitch McConnell urging reforms to the Institutions for Mental Disease (IMD) exclusion be included in the next COVID-19 response package. 

Specifically, the letter asks that H.R. 5006, the Expanding Access to Inpatient Mental Health Act, legislation introduced by Representative Emmer, be included in the next COVID-19 relief package. H.R. 5006 would provide greater access to critical mental health treatment. The bill eliminates an arbitrary cap on reimbursement for inpatient mental health care, by reforming the IMD exclusion, which has bipartisan support and was most notably included in the President’s FY2021 Budget.

"Our nation was facing a mental health crisis prior to the pandemic, and the current circumstances have only heightened that crisis. Our need for mental health care will continue to increase and access should too.” said Emmer. “I have urged the House and Senate leadership to prioritize this effort to ensure resources and access are available. We can, and should use this time in our nation’s history to provide the support our fellow Americans desperately need, and nothing is more vital than mental health."


The IMD exclusion has served as a major barrier for individuals seeking inpatient behavioral health since it was enacted in 1965. Initially, it was enacted to ensure state responsibility for mental health care treatment. While well intentioned, this exclusion has severely limited individual’s access to proper mental health care. An IMD facility includes any facility with more than 16 beds, primarily established and utilized for treatment of mental disease. Anoka Metro Regional Treatment Center is an IMD in the Sixth Congressional District of Minnesota.

The IMD Exclusion limits the number of beds available, the days of which an individual can receive care, and disproportionately effects Medicaid beneficiaries. Rep. Emmer’s, Expanding Access to Inpatient Mental Health Act would eliminate the 15-day cap for Managed Care Organizations (MCOs) and Prepaid Inpatient Health Plan (PIHP) beneficiaries receiving care in an IMD. This would allow individuals to receive care for the appropriate amount of time required to treat their mental illness.

Read Representative Emmer’s letter here

Read the text of the Expanding Access to Inpatient Mental Health Act here