In terms of both current reform efforts and possible changes ahead, behavioral health policy is undergoing major shifts that are likely to have a significant impact on the ability of all individuals in the U.S. to access the behavioral health services they need. With the start of 2026, new federal and state laws, administrative actions, and pilot programs are all contributing to the rewriting of funding, regulation, and delivery of behavioral health services. For both patients and providers, these shifts in behavioral health policy can be equally regarded as opportunities and as fears.
On the one hand, there will be positive developments because some behavioral health policy changes are promoting integration – the treatment of mental health, substance use, and physical health in a coordinated manner rather than as separate entities. A change in reimbursement and payment models that rewards coordination and outcomes will encourage clinician’s to track whether or not their patients are getting better, as opposed to just counting how many times a patient came to the clinic. These changes should theoretically make the access to mental health treatment easier, and provide less fragmentation.
On the other hand, behavioral health policy will also be providing a tighter safety net in an alarming way. Due to changes in eligibility and funding, the single largest payer for behavioral health treatment, Medicaid, is projected to be covering millions of fewer people in the next ten years. According to the Congressional Budget Office, by FY2034 nearly 12 million people will lose their Medicaid coverage, with many more losing subsidized marketplace insurance. Research has shown that going without insurance causes increased levels of depression, anxiety, and insecurity about basic necessities such as food and housing.
The changes made to behavioral health policy could mean longer wait times and fewer choices for low-income Americans and individuals with serious mental illnesses. Clinicians have a lot of patients who are confused by what is currently covered and what is expected to change in the near future. Advocates for the care of the mental health population are advocating for the assessment of human costs associated with behavioral health policy decisions versus just looking at the financial line items in the budget as lawmakers make decisions on this issue.
There is positive news as various states are being proactive and using their newly afforded flexibility to expand the use of Certified Community Behavioral Health Clinics, enhance their Crisis Systems and create greater equity in obtaining access to mental health services, and doing all of this in the manner that citizens have indicated they want. If done right, by 2026 we should see behavioral health policy move closer to what citizens have indicated as their needs for mental health services (affordable, continuity of care and dignity-based service delivery).
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