Medicaid is the nation’s single largest payer for mental health and substance use treatment and covers nearly one-third of adults with mental health conditions and one-fifth of adults with substance use disorders. Medicaid is a cornerstone of state mental health systems, supporting care for children, parents, veterans, seniors, and people with disabilities in every state.
In July 2025, Congress passed H.R. 1, which made major changes to Medicaid and could leave millions of people across the country without mental healthcare. Since the passage of H.R. 1, Inseparable and partners have worked to support state policymakers to navigate these changes and keep people connected to care.
Inseparable and Mental Health America have created two resources for states and policymakers to help navigate the changes to Medicaid and strengthen state programs to continue to protect access to care.
This guide offers Medicaid directors, policy leads, and eligibility staff operational guidance for using existing administrative data to identify individuals with substance use disorders or disabling mental conditions who qualify for an exemption from community engagement requirements.
Templates for documenting condition codes and supporting data your state will use are provided in the appendix and linked below.
This guide is intended primarily for state Medicaid directors and addresses key decision points, timelines, and implementation considerations as states navigate H.R. 1’s effects on enrollees with substance use disorders and mental health conditions.
Learn how to align Medicaid and SNAP data systems to prevent eligible individuals from being wrongly subject to new work requirements. This toolkit helps states map exemption overlap and build cross-program data strategies.
Click on your state to view a detailed factsheet on how proposed Medicaid cuts could impact mental health and substance use care in your community. For a factsheet with nationwide data, click here.
To view the full report, Medicaid is Mental Health: State-by-State Impacts of Proposed Cuts, click here.
Please note that these state factsheets were prepared prior to the passing of H.R. 1.
Last Updated: June 2025
Click here for a full list of citations for the state factsheets.
Please note that these state factsheets were prepared prior to the passing of H.R. 1.