Mental Health & Substance Abuse NAICS 621420, 623220

Nov 10, 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 are a key political flashpoint fueling the ongoing government shutdown, according to Investopedia. Congressional Democrats say that they won’t vote to reopen the government without action on subsidies and other health care issues, while GOP leaders say they won’t negotiate on health care reform while the government is shut down. 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 and substance abuse professionals 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 and substance abuse centers rely primarily on insurance companies, managed care organizations, and government programs including Medicaid as their main sources of revenue. 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.

• All 50 states and the District of Columbia have seen fentanyl-related drug deaths decrease to levels not seen since 2020, according to an analysis of US overdose data conducted by researchers at the University of North Carolina at Chapel Hill. Demand for substance abuse treatment may decrease if the decrease in fentanyl-related drug deaths is due at least in part to a decrease in fentanyl use. "We are on track to return to levels of [fatal] overdose before fentanyl emerged," said Nabarun Dasgupta, lead researcher on the project which examined overdose records from the Centers for Disease Control and Prevention. Drug deaths in the US are down roughly a quarter, according to provisional Centers for Disease Control data. That includes fentanyl and other illicit drugs like cocaine and methamphetamine.
• Mental health and substance abuse industry employment and wages for nonsupervisory employees increased slightly during the first seven months of 2025, according to the US Bureau of Labor Statistics (BLS). Mental health and substance abuse hospitals increased prices moderately during the first eight months of 2025, according to the BLS.