While some are condemning and others applauding the Supreme Court decision on health care reform, the decision leaves in place federally mandated discrimination against people with mental illness. As I pointed out with Mary Zdanowicz in this Washington Post op-ed
For the most severely mentally ill, private insurance is essentially meaningless. Because of their illnesses, most are indigent, and private insurance is a luxury they cannot afford....Medicaid...covers their care, except for a single exception--inpatient care in psychiatric hospitals. The federal government's Institution for Mental Diseases (IMD) exclusion prohibits Medicaid from reimbursing for most individuals who need care in a psychiatric hospital. If you have a disease in your heart, liver or any other organ and need treatment in a hospital, Medicaid contributes. But if you have a disease in your brain and need care in a psychiatric hospital, Medicaid does not.The ruling by the Supreme Court does not change this. States will continue to declare mentally ill who are hospitalized 'well', and discharge them sicker and quicker into the community while pretending that is humane care. As a result of this, many people with serious mental illness will go shelters, others to jails and prisons, and too many to morgues.
Health Care reform that leaves out the most seriously mentally ill is a national shame.