Trump Has Tried to Slash Funds for Mental Health Care Despite Post-Shooting Rhetoric

While President Donald Trump has long attempted to link mass shootings to mental health issues, he has simultaneously proposed budgets that would strip hundreds of billions from Medicaid, the country's largest payer of behavioral health services.

As he has done after past mass shootings—for example, the Thousand Oaks, California shooting in November; the Parkland, Florida shooting in February 2018 and the Sutherland Springs, Texas shooting in November 2017, for example—Trump blamed mental illness during his remarks Monday about two killing sprees that occurred over the weekend.

Yet Trump has sought to slash vast amounts of money from Medicaid in his budget proposals since taking office, despite previously promising not to cut the program's funding. In March, he proposed slashing almost $1.5 trillion from projected Medicaid spending.

The Kaiser Family Foundation said that in 2015, Medicaid "covered 22 percent of non-elderly adults with mental illness and 26 percent of non-elderly adults with serious mental illness." Cuts to the program would significantly impact mental health coverage available to Americans.

Medicaid is "the most critical part of any conversation about mental health care," Jennifer Snow, the acting National Director of Advocacy and Public Policy at the National Alliance for Mental Illness, told Newsweek. "It's the nation's largest payer for mental health and substance abuse services."

The Trump administration has also permitted states to impose work requirements for individuals seeking Medicaid, further inhibiting access to mental health care.

Although the White House has permitted eligibility requirements as a manner of helping people get jobs—a claim that appears dubious after a recent study from the New England Journal of Medicine—the Center on Budget and Policy Priorities (CBPP) has said that Trump's decision to allow eligibility requirements will harm those with mental illnesses. While individuals considered "medically frail" are exempted from working, CBPP said that this definition excludes "many people with mental health conditions." Some others could have trouble proving that they qualify for an exemption.

"Unfortunately, the Trump Administration has approved states' requests to limit Medicaid eligibility in ways that fall particularly heavily on individuals with cognitive difficulties, for example by imposing work requirements as a condition of enrollment," Rebecca Farley David, the National Council's Vice President of Policy and Advocacy, told Newsweek by email.

Additionally, Trump has proposed provisions that undermine some of the significant expansions of the Affordable Care Act (ACA). His push to enhance short-term limited duration plans, which often don't provide cover for mental health illnesses, can impact mental health coverage that was improved by the ACA's expansion of Medicaid.

"The Trump administration has expanded short-term insurance plans, which are not required to cover mental health care and typically exclude people with pre-existing conditions, including those with serious mental illness," Larry Levitt, the Executive Vice President for Health policy at the Kaiser Family Foundation, told Newsweek in an email.

President Donald Trump makes remarks in the Diplomatic Reception Room of the White House on August 5. Alex Wong/Getty Images

Trump's proposals haven't always sought to cut funding for mental health programs, but his suggested increases pale in comparison to the Medicaid cuts he has pursued. His Fiscal Year 2020 request sought to add $115 million to the Substance Abuse and Mental Health Services Administration (SAMHSA) program.

But this proposal merely increased funding "by pennies toward SAMHSA while gutting Medicaid," Snow said.

Update: a previous version of this article incorrectly referred to the National Alliance on Mental Illness as the National Alliance on Mental Health. The name has been changed.