Mental Health Practitioners NAICS 621330

Nov 13, 2025 - ACA Insurance Premiums May Increase Significantly

• Affordable Care Act (ACA) premiums may increase significantly in 2026 because enhanced premium tax credits for policies are set to expire at the end of 2025. Insurance coverage is a key determinant in accessing mental health services, according to health policy research firm KFF. The credits were a key flashpoint fueling the month-long federal government shutdown, according to Investopedia, but a November 12 deal to reopen the government only pushes a decision on ACA premium tax credits to December. The expanded credits, first introduced by the Biden-era American Rescue Plan, increased the previous subsidy amount and eliminated the eligibility income cap. The credits are commonly credited with making Obamacare plans cheaper, doubling signups, and driving the uninsured rate to record lows, according to Investopedia. Center on Budget and Policy Priorities researchers found that without the enhanced premium tax credits, an average ACA enrollee will see their out-of-pocket premiums more than double, spiking by $1,000 a year. People in their sixties with middle incomes could pay $25,000 more.
• Hundreds of billions of dollars in cuts to federal health care spending passed as part of the 2025 Budget Reconciliation Act, also known as the One Big Beautiful Bill Act, could negatively impact mental health practitioners who work in schools. Schools are legally required to provide certain medical services, such as for students with disabilities who are enrolled in a special education program. Under the federal Individuals with Disabilities Education Act, which governs special education services, public school students with disabilities must be placed on education plans tailored to their needs. Such plans can include medical services such as physical therapy, mental health counseling, or speech pathology. Medicaid cuts in schools are expected to lead to school health staff layoffs, a reduction in mental and behavioral health services, and a reduction in resources for students with disabilities, according to the Healthy Schools Campaign. The 2025 Budget Reconciliation Act is estimated by Healio to include $930 billion in Medicaid cuts over 10 years. Mental health practitioners are highly dependent on government programs and third-party insurers to pay for services. Nearly 12 million more people may be uninsured by 2034, with many losing coverage because of the Medicaid provisions in the bill, according to a US Congressional Budget Office analysis. For the first time in the Medicaid program’s nearly 60-year history, certain able-bodied adults aged 19 years to 64 years will be required to work, participate in job training, volunteer, or enroll in school at least 80 hours a month to maintain their Medicaid benefits. This will also be required for parents of children aged 14 years and older.

• Medicare payments to Medicare Advantage plans are expected to increase an average of 3.7%, or over $16 billion in 2025, according to the Centers for Medicare & Medicaid Services. Medicare Advantage plans are required to cover all mental health and substance use disorder services covered under Medicare Parts A and B. The finalized the Calendar Year 2025 Rate Announcement for Medicare Advantage is projected to result in payments of between $500 and $600 billion in Medicare Advantage payments to private health plans in 2025.
• Mental health industry employment increased slightly and average wages for nonsupervisory employees decreased slightly during the first seven months of 2025, according to the US Bureau of Labor Statistics. US mental health industry sales are forecast to grow at a 5.75% compounded annual rate from 2025 to 2029, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund, Inc.