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As of October 2023, several states in the U.S. have significantly restricted or eliminated the insanity plea, but not all have done so. Notably, states like California, New York, and Texas still allow the insanity defense, albeit with varying standards and procedures. Others, such as Kansas and Idaho, have made substantial changes to how the plea is applied, but they have not entirely eliminated it. Overall, the insanity plea continues to exist in many states, albeit under different guidelines.

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