Changes in mental health policies that will occur under federal law in 2026 are causing a major transformation of who gets mental health care services and who will not. As Medicaid is the largest single source of funding for mental health services in the U.S. and is expected to cover about a 25% of the U.S. mental health and substance abuse service system, some estimates predict that over 12 million people will no longer qualify for Medicaid by 2034. Not only can these people expect to receive fewer or different mental health services, but they will also likely have to either go without health insurance or pay lower premiums for very limited plans, all of which will have considerable emotional and financial implications for those individuals.
Studies already demonstrate that when individuals lose their Medicaid health insurance, they experience significant increases in their rates of anxiety, depression, food insecurity, and inability to function, which suggests that any alterations made to mental health policy related to insurance coverage will impact the public’s health.
Furthermore, the second administration of President Trump has proposed to consolidate the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA) into a new organization called the “Administration for a Healthy America,” and to reduce support for community mental health centers, suicide prevention programs, substance abuse treatment, and workforce development programs by approximately $1 billion. critics of these shifts in mental health policy argue that these changes will create more fragmentation in the services being provided and will reduce the amount of expertise that has been developed over many years.
There are hints of good news in the field of Medicare’s support for primary and behavioral care integration: increased reimbursement of both collaborative care models and team based treatment, in addition to the support of some digital tools. These changes to mental health policy may improve access to mental health services through traditional healthcare providers (e.g., family physicians).
Those who utilize services will often experience mental health policy changes through an increase in waitlists for mental health services, clinics closing down, and in some communities, the experience of integrated systems of care. Advocates are encouraging individuals to: stay informed, share their individual experiences, and advocate for their mental health to those who have the power to make changes to mental health policy.
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