After the school shooting in Florida this week, President Trump vowed to “tackle the difficult issue of mental health.” But the president's proposed budget would cut many programs that provide mental health services.
President Trump's proposed budget does include some increases in funding for mental health. However, Dale Hamilton of Community Health and Counseling Services, says the overall takeaway for Maine is that “President Trump's budget will not advance access to mental health services.”
One major way the budget would erect barriers to care, says Hamilton, are proposed cuts to Medicaid. The health care program for low income individuals is the single largest payer in the United States for behavioral health services, according to the nonpartisan legislative agency Medicaid and CHIP Payment and Access Commission. President Trump wants to put spending caps on Medicaid which, Hamilton says, would limit the ability of service providers to deliver care. The President's proposed budget would also end Medicaid expansion and use that money to create health care block grants.
“The challenge around accessing services is already huge,” says Hamilton. “But then the concept of ending Medicaid expansion is just horrific.”
Maine voters passed a referendum last year to expand Medicaid. Exactly when or how it will be implemented is under question, though, due to opposition by Governor LePage. But Jenna Mehnert, the executive director of the Maine branch of the National Alliance on Mental Illness, says it's a part of the Affordable Care Act that should be preserved, as it is an important way to increase access to mental health care.
“Is it in everybody's best interest, or is it reserved for the few who can pay?” says Mehnert. “The reality is that all of society suffers when people cannot access physical health and mental health services.”
President Trump's proposed budget also cuts mental health funding under the Substance Abuse and Mental Health Services Administration. Some programs would see an increase, including the US Department of Veterans Affairs, which would get about $470 million for suicide prevention. But overall, says Hamilton, the President's budget is a continuation of what he's witnessed for more than two decades: insufficient mental health funding.
I just don't think we have a priority in the nation at this point to provide those resources,” says Hamilton.
It's something that Hamilton says tends to be a part of initial discussions only after an incident like what happened in Parkland, Fla.