Anne Swerlick
May 26, 2017

Children, Adults Who Need Mental Health and Substance Abuse Assistance at Risk Under House Health Care Legislation

This post was last updated on September 29, 2021. As new policies are announced, FPI will update this page.

As Florida’s response to COVID-19 takes front and center, concern grows for low-income families who struggle to take precautions against the spread of the virus. Although Congress has passed the Families First Coronavirus Response Act to address, at least in part,  the public health crisis and economic fallout from COVID-19, many barriers continue to keep struggling families from accessing the assistance they need during the pandemic. As Florida initiates policies implementing the Act and addressing other barriers to the safety net, FPI will update this form. When available, hyperlinks are provided to agency documents or statements that provide greater detail  about the new policy.

On March 22, 2020, FPI and 44 other organizations sent a letter to Governor DeSantis, leadership in the Legislature and agency heads to urge action on 47 specific policy changes to reduce unnecessary barriers for Florida’s safety net programs in response to the COVID-19 pandemic. See the letter here.

Florida ranks 50th in the nation in funding for mental health services. At the same time, more than 350,000 Floridians received such treatment through Medicaid. Another 4,000 died in Florida from opioid overdoses alone. A clear and compelling need exists for expanded treatment to address mental illness and substance abuse.

The Florida Medicaid program is a major source of coverage for mental health and substance use services. But the House health care reform bill, the American Health Care Act (AHCA), could deprive more than 4 million Americans of mental health and opioid addiction treatment.[1] In Florida, more than 352,000 people on Medicaid received treatment for mental health or substance abuse services at a cost of almost $400 million during Fiscal Year 2015-16.[2]Sixty-one percent of these costs were covered by federal Medicaid funds.

Under the AHCA, Florida is slated to lose more than $7 billion over the next decade.[3]  State policymakers will have little choice but to cut eligibility, benefits or provider payments. Under any of these scenarios, it will be a huge step backwards. Notably, the governor has just declared a public health emergency around the opioid epidemic- claiming nearly 4,000 Floridians as victims in 2015 alone.[4] And Florida already has the dubious distinction of being 50th in the nation on spending for mental health and substance abuse.[5] There will be little hope of improving this benchmark if the AHCA becomes law.

Florida’s current Medicaid program covers services for adults such as psychiatric physician and hospital services, rehabilitation and intensive case management for persons with serious mental illness. This is in addition to coverage for prescription drugs, including naloxone, a life-saving medication for persons who have overdosed.

Under current Medicaid law, these services are characterized as “optional.” If the AHCA becomes law, these services will be prime candidates for the chopping block with $7 billion of federal cuts looming on the horizon.

Children’s services will also be a target. Currently, they are covered by a comprehensive pediatric benefit package — Early & Periodic Screening, Diagnosis and Treatment (EPSDT), which includes mental health and substance abuse treatment. Without continued access to these services, many Florida children and youth will unnecessarily suffer the devastating life-long consequences of untreated mental illness and substance abuse.

As Mental Health Awareness month comes to an end, the importance of Medicaid in providing essential life-saving mental health and substance abuse services cannot be overstated.


[1] Solomon, J., Don’t Be Fooled: $15 Billion More For House GOP Health Bill’s Stability Fund Will Undo Little of Bill’s Harm on Mental Illness and Substance Use Disorders, Center on Budget & Policy Priorities, 2017. Accessed via:

[2] Agency for Health Care Administration, Report to the Senate Health and Human Services Appropriations Subcommittee, January 11, 2017, Behavioral Health Services Revenue Maximization Plan, p. 6. Accessed via:

[3] Center on Budget & Policy Priorities, House Republican Health Plan Would Mean More Uninsured, Costlier Coverage in Florida, 2017. Accessed via:  http://

[4] Florida Executive Office of the Governor, Executive Order 17-146, May 3, 2017. Accessed via: http://

[5] Florida Report Card: Florida Needs to Go Back to School, Florida Policy Institute, 2017.

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