Sign on to the National Support Letter for the Medicare Mental Health Inpatient Equity Act of 2025

On July 22nd, Congressmen Bill Huizenga (R-MI) and Paul Tonko (D-NY) reintroduced the Medicare Mental Health Inpatient Equity Act of 2025 (H.R.4619), which would permanently repeal the Medicare 190-day lifetime limit for inpatient psychiatric care.

Currently, Medicare caps treatment for mental illnesses at a 190-day lifetime limit on inpatient psychiatric hospital services. The 190-day limit currently does not apply to psychiatric units in general hospitals, and no other lifetime limit exists for any other Medicare specialty inpatient hospital service.

Substance use disorders (SUDs) and mental health disorders are chronic diseases, long-term health conditions that require ongoing medical care and impact daily life. Substance use and mental health disorders require treatment for a number of years, even the entire lifespan.[1] A cap of 190 days of lifetime treatment may act as a barrier to accessing treatment for a person's chronic illness who requires ongoing treatment.

Both substance use disorder (SUD) and mental health disorders are common in the Medicare-eligible population. Approximately 1.7 million Medicare beneficiaries reported past-year SUDs,[2] and 1 in 4 seniors suffer from a mental health issue.[3] According to a recent study published in the American Journal of Preventive Medicine, Medicare beneficiaries with SUDs were more than twice as likely to have past-year serious psychological distress compared to those without SUDs. Accessing effective treatment remains a barrier to addressing co-occurring SUD and mental health disorders. In 2023, about 38,900 people exhausted the full 190-day lifetime limit on inpatient psychiatric coverage, while another 10,400 were within 15 days of reaching the cap.[4] These restrictions often force premature dischargers, disrupt treatment plans, and increase the likelihood of relapse, hospitalization, and emergency care.

The legislation aims to ensure that individuals with mental illnesses receive the same level of access to inpatient care as those with other health conditions through:

• Eliminating the lifetime limit on inpatient psychiatric hospital care under Medicare, which currently caps coverage at 190 days;

• Ensuring parity between mental and physical health care by aligning Medicare policy with private insurance plans that no longer impose similar restrictions;

• Improving access to critical inpatient psychiatric treatment for seniors, individuals with serious mental illness, and low-income beneficiaries who rely on Medicare; and

• Modernizing Medicare policy to reflect current standards of care and reduce the long-term costs and consequences of untreated or undertreated mental health conditions.

Sign On to the National Support Letter

Addiction Policy Forum invites your organization to sign the national sign-on letter. 

A copy of the letter can be found here.

To sign your organization on to the letter, click here.

References

[1] Fleury, M. J., Djouini, A., Huỳnh, C., Tremblay, J., Ferland, F., Ménard, J. M., & Belleville, G. (2016). Remission from substance use disorders: A systematic review and meta-analysis. Drug and Alcohol Dependence, 168, 293–306. https://doi.org/10.1016/j.drugalcdep.2016.08.625

[2] Parish, W. J., Mark, T. L., Weber, E. M., & Steinberg, D. G. (2022). Substance use disorders among Medicare beneficiaries: Prevalence, mental and physical comorbidities, and treatment barriers. American Journal of Preventive Medicine, 63(2), 225–232. https://www.ajpmonline.org/article/S0749-3797%2822%2900104-0/abstract?uuid=uuid%3Ae9835a0b-ad72-42ca-8a7d-c96f8973b374

[3] American Psychological Association. (2021) Older Adults: Health and age-related changes. https://www.apa.org/pi/aging/resources/guides/older

[4] Medicare Payment Advisory Commission, Report to the Congress: Medicare and the Health Care Delivery System, Chapter 6: "Behavioral Health Services in the Medicare Program. ( June 2023), https://www.medpac.gov/wp-content/uploads/2023/06/Jun23_Ch6_MedPAC_Report_To_Congress_SEC.pdf