Congress recently passed legislation that threatens to devastate the most vulnerable members of our community—both locally and across the nation. The reconciliation bill, better known as the “Big Beautiful Bill,” will result in hundreds of thousands of North Carolinians and millions of Americans losing access to healthcare coverage and other basic necessities.
At Jewish Family Services (JFS), we serve individuals and families who already face barriers to mental health care, food security, and economic stability. Many of the people who rely on our services are Medicaid recipients or Supplemental Nutrition Assistance Program (SNAP) beneficiaries. The deep cuts proposed in this bill directly undermine the lifelines that make our work possible —and that keep our clients safe, stable, and supported.
At the heart of the bill is a proposed $1 trillion cut to Medicaid. This would affect up to 17 million Americans, many of whom are individuals living with mental illness—a group that makes up a significant portion of Medicaid recipients. The National Alliance on Mental Illness (NAMI) stated that these cuts “will make it significantly harder for people with mental illness to access, afford, and keep their mental health care.”
We are facing a future where therapy, medication, and crisis services—most of which are funded by Medicaid—could become unaffordable or disappear altogether. This isn’t merely an inconvenience; it is a crisis with immediate consequences for people who rely on mental health support.
The bill also slashes support for SNAP, a vital lifeline for millions of low-income Americans. Food insecurity and financial instability are strongly linked to depression and anxiety. When families face hunger and stress, mental health doesn’t just decline in theory—it breaks down in real homes, in real time.
In rural communities, where food insecurity is already a chronic issue, the projected $155 billion reduction in Medicaid funding over the next decade threatens the closure of local clinics and hospitals. Although a temporary $50 billion “bridge fund” has been allocated to rural hospitals, the overall cuts far outweigh this short-term relief. The closure of these facilities—and the telehealth services many provide —will increase isolation and hardship, especially for seniors and people with disabilities.
Compounding the issue, the bill introduces new Medicaid work requirements and administrative hurdles, set to take effect in 2026. These requirements disproportionately impact people with serious mental illness, who may not be able to work or navigate complex bureaucratic systems. As a result, many will lose coverage—not for unwillingness to comply, but because the system becomes unmanageable . This leads to a devastating cycle: no therapy, no medication, no stability.
The American Hospital Association warns that such immediate overhauls will force hospitals to cut services or close behavioral health units. The American Civil Liberties Union (ACLU) has also raised the alarm, noting that Medicaid supports mental health and substance use services for more than 70 million people—services that will be jeopardized by these reductions.
People already living with mental illness now face the additional anxiety of losing health insurance, essential medications, and consistent care. Families, caregivers, and service providers —already under strain—are bracing for impact as safety nets are removed. Entire communities could unravel under the weight of these changes.
Mental health advocates are not giving up. NAMI’s Protect Medicaid. Protect Mental Health campaign has generated more than 155,000 calls and emails urging Congress to reconsider. Grassroots organizing and legal challenges are underway, but even the most committed states will likely be unable to offset the enormous fiscal gap created by these federal cuts.
The passage of the One Big Beautiful Bill Act is more than a political moment—it marks a turning point in America’s mental health landscape. It threatens to dismantle critical safety nets, destabilize access to food and healthcare, and erect barriers that leave millions more vulnerable. These effects aren’t theoretical or distant. They are happening now.