Failure to Raise Spending Caps Threatens Mental Health Resources

An estimated 25.5 million adults with a mental health condition didn’t receive servicesof any kind in 2016. Yet federal funding for the Community Mental Health Services Block Grant (MHBG), a key program providing services to adults with serious mental illness and children with severe emotional disturbance, will at best stay flat in 2018 — which is effectively a cut after accounting for inflation. That’s just one example of how the 2011 Budget Control Act’s (BCA) caps on funding for annually appropriated programs are impeding investments (and often forcing harsh cuts) in critical domestic priorities.

MHBG resources are distributed to all 50 states, the District of Columbia, and the eight territories on a formula basis and then distributed to local community mental health providers. MHBG pays for services that Medicaid doesn’t cover and fills important gaps like case management, provider administrative costs, and outreach and engagement. Its funding for services is particularly important for the uninsured, so cuts in MHBG funding would be especially harmful for people in the 19 states that have not implemented the Affordable Care Act’s (ACA) Medicaid expansion.

MHBG funding has risen in inflation-adjusted terms since 2010. Current House and Senate bills that fund MHBG would keep 2018 funding at the 2017 level, resulting in a 2 percent cut after accounting for inflation. Earlier proposals were far worse. President Trump’s 2018 budget and the House Appropriations Committee’s original bill proposed drastic cuts of 28 percent and 27 percent, respectively. The full House reversed the cut in the Appropriations Committee’s bill, but Congress hasn’t yet enacted the final 2018 bill, leaving open the possibility that MHBG won’t be protected from further cuts. And, as noted, the pending House and Senate bills only provide flat funding, rather than a funding increase that would enable states to serve more people.

– Center on Budget and Policy Priorities

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