Update on Trump's Addiction Treatment Policies, and What the Future May Hold for Behavioral Health

In previous posts, we covered predictions on the Trump administration’s effects on the addiction treatment and recovery residence communities. Change has been moving fast as the Trump administration makes big moves in the Executive Branch and appoints cabinet members like Robert F Kennedy, Jr. to head the Department of Health and Human Services. Today, we will update our previous predictions and highlight some new issues to watch as the developments unfold. 

Will the “Parity Rule” be reversed and weaken mental health and addiction treatment coverage for Americans? 

This issue is very pressing for the behavioral health community and may deeply affect the bottom line at many organizations providing addiction treatment services. 

In 2008, the Mental Health Parity and Addiction Equity Act was passed to ensure that health plans provide coverage for addiction treatment, just as they would for any health condition. Last year, in 2024, the “Parity Rule” was added to bolster these protections, and address the so-called “provider shortage” by requiring reimbursement rates for addiction treatment services that are on par with reimbursement rates for similar healthcare services. It also sought to limit “red tape” barriers to care, such as certain issues surrounding Prior Authorization requirements and denials.  

In January 2025, an employer’s trade group brought a lawsuit challenging the “Parity Rule.” Trump has argued for less government regulation of business, and limiting healthcare regulations falls in line with that overall trend. It is possible that Trump will support the reversal of the “Parity Rule.” He may even support the repeal of the Mental Health Parity and Addiction Equity Act entirely. With the situation on the ground changing day-to-day, it is difficult to know what’s next in terms of continued protections for behavioral healthcare coverage. 

Mental health parity is a pet issue of the Kennedy Forum, where RFK’s cousin, Patrick Kennedy, champions equal access to care for people with SUD. It’s possible that he may influence RFK and the Trump administration to uphold the “Parity Rule” and the Mental Health Parity and Addiction Equity Act. Time will tell. 

Trump’s immigration policies likely to affect some addiction treatment providers, centers, and hospital-based programs 

On his second day of office, Trump issued a statement through a DHS Spokesperson that stated his intentions to escalate the deportation of people without legal status in the US. In the past, there was a long-term policy that created “safe spaces” for undocumented people in “sensitive locations’ like schools, places of worship, religious events, and hospitals. It was typically not done to arrest people without legal status in the US in these locations. Trump’s statement changed that. Red states and blue states have responded to these instructions differently, with red states embracing the policy change and blue states largely indicating resistance to the change. 

This puts healthcare providers - and addiction treatment providers, specifically - in a bind that may prove to be significant in the behavioral health industry. It is difficult to say how this play out long term, but this is an issue to watch.

The 60 day freeze on any new developments in Health and Human Services means addiction treatment providers will not feel any immediate major changes in HHS policy

Trump has placed a “60-day freeze” on all new regulations, including pending regulations, and this freeze extends to any new policies at the Department of Health and Human Services. This means that for 60 days, there will be no new regulations issued, but that at the end of 60 days, there is likely to be a wide range of regulations or rule changes issued from the administration. That date falls on March 21, 2025.  

Robert F Kennedy confirmed as head of Health and Human Services - What it means for addiction treatment

With Kennedy now confirmed as the head of HHS, it’s likely he will move ahead to expand “healing camps” based on the therapeutic community model for addiction treatment seen in places like San Patrignano. Details on these healing camps are scarce, but in social media posts, Kennedy has stated that residents might be given a choice between incarceration and farm life, suggesting some element of coercion may be involved in this model of care. 

If Kennedy’s “healing camps” plan moves forward, it would represent a huge shift in addiction treatment in the United States. It’s unclear if these camps would be publicly or privately owned, how many there would be, and when they might be built. It’s likely these therapeutic communities would not allow evidence-based treatments like methadone, buprenorphine, or suboxone. We’ve also seen reports that RFK’s skepticism about mental health drugs, like SSRIs and ADHD medications, may extend to bans on these treatments at the new “healing camps,” should they come to fruition. 

Other blog posts on the Trump administration’s policies and plans that may affect addiction treatment providers and behavioral healthcare

Forecasting Trump's Behavioral Health Plan for Addiction Treatment Providers in 2025

2025 Federal Addiction and Mental Health Treatment Policies Under the Trump Administration Part 2

Predictions for Trump's Behavioral Health Policy for Recovery Residence  Operators in 2025

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Medicaid Unwinding and State Behavioral Health in Montana, Minnesota, New York, Arizona, Colorado, Tennessee, and Washington

Nearly 40% of Medicaid enrollees meet diagnostic criteria for a mental or behavioral health condition. As federal requirements to retain all Medicaid enrollees during the pandemic begin to fade or “unwind,” it’s the states themselves that have control over the fate of millions of Medicaid enrollments. 

Let’s look at how these changes are playing out in 7 key states: Montana, Minnesota, New York, Arizona, Colorado, Tennessee, and Washington. 

Montana: State Medicaid Updates During the Unwinding of Continuous Enrollment

Medicaid enrollment in Montana flourished during the pandemic and the continuous enrollment period. 

Historically, Montana has a bad track record for Medicaid accessibility. The state denies more applications than most, so it’s expected that the unwinding process in Montana will result in many uninsured residents. States have 12-14 months to complete the “unwinding” process, but Montana has decided on a 10 - 12 month “unwinding” or reprocessing of Medicaid eligibility. 

Montana’s Department of Public Health and Human Services began checking for Medicaid eligibility in April 2023. 

Minnesota State: Unwinding Updates for the Phase-Down of Continuous Enrollment

Minnesota released its “Plan to Unwind Continuous Eligibility Coverage” in February 2023. It outlines the history of pandemic-era changes as well as effects on enrollment and then goes on to name challenges to name “renewal challenges” like budgetary constraints, workforce problems and other barriers to state-provided health coverage. 

The plan provides useful details for those anticipating possible changes to their enrollment eligibility. Eligibility will be reprocessed according to the month in which enrollee’s initially applied. They will begin with those who first enrolled in the month of July. Those enrollees will see a determination made beginning sometime in March 2023. MinnesotaCare renewals are slated for quarter 4 of fiscal year 2023.

New York State: A Three Phase Medicaid Unwinding Plan

New York state has created a toolkit to help New Yorkers understand the unwinding process and navigate health care in the post-COVID world. 

New York’s unwinding plan is a three phase one: first, they’ll spread awareness of important coming changes to Medicaid. Second, they’ll help every enrollee update their contact information with the state so that they can communicate renewal information effectively with individual enrollees. Third, they’ll help New Yorkers through the redetermination process and/or help former enrollees migrate to more appropriate coverage.

Arizona: 600,000 Medicaid Patients At Risk of Losing Coverage During Unwinding

Arizona began the Medicaid unwinding process in April 2023. 

Arizona Health Care Cost Containment System AHCCCS maintains a dashboard containing all the states’ information on this post-COVID change. According to a useful factsheet for Medicaid unwinding in Arizona, more than 600,000 members are at risk of losing their Medicaid and/or KidsCare coverage in the state, due to redetermination criteria and invalid personal contact information.

Colorado: About 80% of Members Should Remain After Medicaid Unwinding

Colorado’s Medicaid program swelled by up to 500,000 new members during the pandemic but it is slated to shed quite a few of those new additions soon. 

The state has gone on record saying that it believes that roughly 80% of current Medicaid enrollees will remain after the great disenrollment program is complete. That said, “hundreds of thousands” of enrollees could lose their Medicaid coverage - whether that’s Health First Colorado, or CHP+, the Child Health Plan Plus - during the unwinding process as it’s slated in Colorado. 

Tennessee: Medicaid Unwinding Likely to be Catastrophic for Many in This Non-Expansion State 

Along with Wyoming, Texas, Kansas, Wisconsin, Mississippi, Alabama, Georgia, Florida, and South Carolina, Tennessee is one of the 10 states in the union that has not adopted the ACA Medicaid expansion. That means that enrollees in this state are vulnerable to a “coverage gap” where poverty-level residents may not be “poor enough” to qualify for the state’s ultra-low Medicaid income requirements but “too poor” to qualify for ACA marketplace coverage subsidies. This is a policy issue where the state is essentially signaling they believe the federal government should cover these individuals, while the federal government is signaling the opposite - that the state should pick up the bill.

This makes Tennessee’s Medicaid unwinding plan to be a highly disruptive one for many vulnerable people in Tennessee.  

Washington State: Medicaid Unwinding Likely to be Less Brutal in This Medicaid Expansion Early Adopter

Washington state, like most other states, saw a huge growth in the number of Medicaid enrollees during the pandemic, in part due to Medicaid expansion. The state was an early adopter of Medicaid expansion in 2014. Currently, Apple Health (Washington’s name for its Medicaid program) ensures well over 2 million people. Those individuals with incomes that have shifted below 138% of the federal poverty level will soon lose their coverage due to the Medicaid unwinding process now underway in the state. 

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Behave Health is committed to making it easier - and more profitable - to operate evidence-based, results-focused addiction treatment centers.

Our all-in-one app puts clinical, administration, staff, admissions, alumni, residents, treatment plans, billing, insurance authorizations and more - all at your fingertips.

Get your free trial started today and see why more addiction treatment centers prefer Behave Health.

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