As reported by Dorothy Mills-Gregg in Inside Health Policy, HHS Secretary nominee Robert F. Kennedy Jr. promised to work with senators to repeal the federal ban on Medicaid funding so-called Institutions for Mental Diseases, ensure the Medicare area wage index is fair to rural providers and “fix” the nursing home staffing rule. Kennedy’s comments came during his confirmation hearing before the Senate Finance Committee Wednesday (Jan. 29), where Democrats spent much of their time grilling the nominee on his business dealings and stances on vaccine safety. Meanwhile, Republicans asked the environmental lawyer to work with them on nursing home staffing, retooling the geographic pay index and repealing the so-called IMD exclusion — a ban on using federal Medicaid funds to pay for treatment at a mental health facility with more than 16 beds.

“This is a discriminatory exclusion, and it denies payment for medically necessary care based on the illness that is being treated, and it has perpetuated unequal coverage in mental health care,” Sen. Marsha Blackburn (R-TN) said. “So, if you’re confirmed, when you’re confirmed, will you commit to working with me on repealing this discriminatory exclusion and ensuring equal access to mental health care for Medicaid beneficiaries?”

“Yes,” Kennedy answered.

Congress has previously considered repealing or altering the IMD exclusion, but progress has been hindered by the historically high price tag. Advocates are hoping that will change since the Congressional Budget Office’s latest estimate at then-House Energy & Commerce Committee Chair Cathy McMorris Rodgers’ (R-WA) request found eliminating the IMD exclusion for some or all behavioral health treatments would cost between $7.7 billion and $38.4 billion — far lower than the 2016 proposal’s estimate of $40 billion to $60 billion.”