Disability Rights Florida joins the Consortium for Constituents with Disabilities (CCD) Rights Task Force in opposing H.R. 4022, the Increasing Behavioral Health Treatment Act. If passed, this bill would direct tens of billions of dollars toward institutional care for people with mental health disabilities and substance use disorders—funding that would come at the expense of essential community-based services.
For decades, federal policy has emphasized the rights of people with disabilities to live, work, and receive services in the most integrated setting appropriate to their needs. This bill threatens to undo that progress by weakening the Medicaid rule known as the “Institutions for Mental Diseases (IMD) exclusion.”
Why This Matters
The IMD exclusion, in place since Medicaid was created in 1965, prevents states from using federal Medicaid funds to pay for institutional care in large, freestanding psychiatric facilities. Instead, states are incentivized to build and fund community-based services. This policy emerged in response to the widespread abuse and neglect in institutions and was designed to ensure people with mental health disabilities could live and receive support in their communities with dignity and autonomy.
Repealing the IMD exclusion would not fix the barriers people face in accessing behavioral health services. Instead, it risks funneling massive resources into costly institutional care while leaving the real problem unaddressed: the severe shortage of community-based mental health supports.
The Better Path Forward
Investments in services such as permanent supportive housing, mobile crisis teams, assertive community treatment, supported employment, and peer support have been proven to reduce unnecessary hospitalization and allow people to thrive in the community. These services cost far less than institutional care and align with the values of independence, self-determination, and inclusion that disability rights advocates have fought for over generations.
H.R. 4022 threatens to move us backwards. Disability Rights Florida stands with the CCD Rights Task Force in calling on Congress to reject this harmful legislation and instead prioritize sustainable investments in community-based mental health and substance use disorder services.