Michelle Alyssa Go Act

Bill Number

H.R. 5462

Origin Chamber

House

Congress

119th Congress, Session 1

Policy Area

Health

Status

Introduced

Latest Action

2025-09-18: Referred to the House Committee on Energy and Commerce.

Last Updated

2025-11-18T16:18:16Z

AI-Generated Summary

Purpose

The Michelle Alyssa Go Act (H.R. 5462) aims to expand access to Medicaid-funded mental health and substance use disorder (SUD) treatment by revising the definition of an "institution for mental diseases" (IMD). Currently, Medicaid generally does not cover services in IMDs, a restriction known as the IMD exclusion. This bill creates an exception for smaller, high-quality facilities to allow coverage of their services.

Key Provisions

• Revised Definition of IMD: Amends Section 1905(i) of the Social Security Act to exclude from the IMD definition any hospital, nursing facility, or other institution that:
• Has 36 beds or fewer.
• Meets nationally recognized, evidence-based standards for mental health programs, approved by the Secretary of Health and Human Services (HHS). For facilities treating SUDs, they must also meet standards like those from the American Society of Addiction Medicine.
• Standards Requirements: These include specifications for the types of services provided, hours of clinical care, staffing qualifications, and any additional criteria set by the HHS Secretary.
• Effective Date: Changes take effect 180 days after the bill's enactment and apply to state Medicaid plans starting on that date.

Significant Changes to Existing Law

• Under current law, IMDs—facilities primarily focused on diagnosing, treating, or caring for people with mental illnesses—are largely excluded from Medicaid reimbursement, limiting funding for inpatient mental health care.
• This bill introduces a narrow exception for small facilities (≤36 beds) that demonstrate quality through evidence-based standards, effectively allowing Medicaid to fund services in these settings for the first time in many cases. This does not eliminate the broader IMD exclusion but carves out this specific category.

Potential Impacts

• On Citizens: Medicaid beneficiaries with mental health conditions or SUDs could gain better access to community-based inpatient treatment in smaller facilities, potentially reducing barriers to care and improving outcomes for vulnerable populations, such as those experiencing homelessness or severe mental illness.
• On Government Agencies: State Medicaid programs may need to update their plans to incorporate these facilities, possibly increasing federal matching funds for covered services. HHS will oversee approval of standards, which could streamline or expand mental health funding without major new administrative burdens.
• On International Relations: No direct impacts, as this is a domestic health policy focused on U.S. Medicaid.

Main Stakeholders Affected

• Individuals with Mental Health or SUD Needs: Primary beneficiaries, including low-income adults and children relying on Medicaid for treatment.
• Small Mental Health and SUD Facilities: Operators of facilities with 36 or fewer beds that can meet quality standards, enabling them to receive Medicaid reimbursements.
• State Governments and Medicaid Agencies: Responsible for implementing changes in their programs and potentially shifting resources toward community-based care.
• Federal Government (HHS): Tasked with defining and approving standards, influencing national mental health policy.
• Healthcare Providers and Advocates: Including bipartisan lawmakers (e.g., sponsors from both parties) and organizations focused on mental health reform.

Notable Legal, Constitutional, or Political Implications

• Legal: Strengthens Medicaid's role in mental health by partially addressing the longstanding IMD exclusion, which originated in 1965 to prevent over-institutionalization. No challenges to federal authority are anticipated, as it builds on existing Social Security Act provisions.
• Constitutional: Aligns with Congress's spending power under the Constitution, as it conditions federal Medicaid funds on state compliance without infringing on state rights.
• Political: Bipartisan support (introduced by representatives from both parties) reflects growing consensus on the mental health crisis, potentially paving the way for further reforms. It could reduce reliance on emergency rooms or jails for mental health crises by promoting evidence-based care, though implementation depends on HHS guidance to ensure standards are practical.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. Goldman, Daniel S. [D-NY-10]

Cosponsors (14)

Rep. Barragán, Nanette Diaz [D-CA-44], Rep. Crenshaw, Dan [R-TX-2], Rep. Salinas, Andrea [D-OR-6], Rep. Bacon, Don [R-NE-2], Rep. Clarke, Yvette D. [D-NY-9], Rep. Lawler, Michael [R-NY-17], Rep. Strickland, Marilyn [D-WA-10], Rep. Brownley, Julia [D-CA-26], Rep. Moulton, Seth [D-MA-6], Rep. Tenney, Claudia [R-NY-24], Rep. Nadler, Jerrold [D-NY-12], Rep. Harder, Josh [D-CA-9], Rep. Thanedar, Shri [D-MI-13], Rep. Chu, Judy [D-CA-28]

Recent Actions

• 2025-09-18: Referred to the House Committee on Energy and Commerce.
• 2025-09-18: Introduced in House
• 2025-09-18: Introduced in House

Bill Versions

• Michelle Alyssa Go Act — issued 2025-09-18 — PDF (3 pages)