How Trump’s “Big, Beautiful Bill” Hurts Youth Mental Health - Non Profit News

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On May 22, 2025, House Republicans passed what President Trump has been calling “the big, beautiful bill”—large-scale spending and tax legislation that is currently pending in the Senate.

As anticipated, tax cuts from the 2017 Tax Cuts and Jobs Act are permanently extended in the bill; it also proposes steep cuts to Medicaid, the Children’s Health Insurance Program (CHIP), and the Affordable Care Act (ACA). These are all ways that uninsured and underinsured young people access healthcare in America, including mental healthcare.

These proposed cuts to accessible mental health resources come only weeks after Trump’s Education Department announced its plan to cut approximately $1 billion in mental health grants in American K–12 schools, citing “misuse of funds.”

But against this landscape of cuts, new data show just how desperately youth need mental health services.

Missed Red Flags

The mental health grants slated to be cut by the Trump administration were created in 2022 in the wake of the deadly school shooting at Robb Elementary School in Uvalde, TX. The Bipartisan Safer Communities Act (BSCA) was a rare moment when both Republican and Democratic representatives agreed that young people in the United States needed this extra mental health support. Their conclusion was borne out by data from the World Happiness Report showing that young people below 30 report higher levels of unhappiness, anxiety, and overall life dissatisfaction compared to people over 50—and that the gap between the two age groups is widest in the United States.

After the stress and isolation of the first part of the COVID-19 pandemic and the relentless rhythm of school shootings, the BSCA was a focused effort to try to address the rising levels of anxiety and depression reported by young people—especially after a July 2022 state investigative report of the many “missed red flags and possible motivations” of the Uvalde school shooter.

“Medicaid is one of the most powerful tools for breaking down access barriers.”

Mary Wall, the Education Department’s former deputy assistant secretary for P-12 education, told Chalkbeat that BSCA grants supported 1,500 to 2,000 new mental health providers throughout American schools. Many of the grants were for multiyear contracts, as was the case for Columbia University’s Teachers College, which had its funding abruptly halted by the Trump administration in March.

The program had planned to train its first five graduate students who would focus on “high-need” schools. The K–12 students in Harlem and East Harlem now will not have access to a year of free mental health services; likewise, the trainees were mostly first-generation and/or bilingual students who might not be able to attend graduate school without this funding.

Prerna Arora, an associate professor overseeing the grant for Teachers College, told Chalkbeat, “We were going to be producing professionals who would be working in these settings delivering school-based mental health services for years to come, ideally their entire careers. We are in desperate need of these types of professionals.”

“Fractured Futures”

Last spring, healthcare information company Surgo Health surveyed more than 4,500 young people between the ages of 10 and 24 as part of the Youth Mental Health Tracker initiative. The aim was to gather data and stories from youth across America about their individual experiences and health challenges. Survey data was combined with information from ThriveAtlas™, an interactive map that zeroes in on youth wellbeing data collected in every county.

The first report of these findings was published in April. Titled Fractured Futures: ThriveAtlas™ Maps the Risk to Youth Mental Health Amid Looming Medicaid Cuts, the report details where kids are failing to thrive, why, and how policy changes can help.

Three out of four congressional districts have multiple high-risk factors for youth mental health.

Sema Sgaier, CEO and cofounder of Surgo Health, explained in a press release, “You can’t fix what you don’t understand. This data equips every Member of Congress with a clear, district-level map of need, so we can avoid making one-size-fits-all decisions and start investing in the places that need it the most.”

The report’s researchers identified six key themes that threaten the wellbeing of young people in the United States: “Each theme highlights a different point of system failure and a different way Medicaid, especially Section 1115 Waivers, helps hold those systems together.” (Section 1115 Waivers allow states to modify their Medicaid plans, including waiving certain federal requirements.)

The six themes of the ThriveAtlas data are:

• Limited Wellness Practices: Classified as notable gaps in physical activity and sleep hygiene, Medicaid cuts could further “reduce access to preventative and community-based services that support wellness behaviors.” These services include annual check-ups where physicians can address chronic conditions and mental health. “This erosion of preventative care infrastructure may contribute to worsening mental and physical health outcomes” (7).
• Provider Shortage: A reduced Medicaid budget might lead to “lower provider reimbursements…driving providers out of the Medicaid network and reducing service availability” (8). Among the top districts that would immediately further exacerbate mental healthcare provider shortages are four Republican-led districts in the South: Tennessee’s Fourth (Rep. Scott DesJarlais), Alabama’s Third (Rep. Mike Rogers) and Fourth (Rep. Robert Aderholt), and Florida’s Eighteenth (Rep. Scott Franklin).
• Accessibility Barriers: “Medicaid is one of the most powerful tools for breaking down access barriers,” (8) including expanding rural internet access, covering young people via affordable healthcare expansion, and helping them get to appointments through ride services.
• Socioeconomic Hardship: Many people in the United States already delay treatment when faced with the possibility of expensive medical bills. For families who are struggling financially, Medicaid helps patients bridge the gap and get care that would otherwise be completely out of reach.
• Negative Life Experiences: Some districts have a higher proportion of residents who face more daily trauma and/or violence. Medicaid programs help offset the harm to mental health through community-based programs and trauma-informed care and case management.
• Limited Support and Belonging: In communities with high levels of risk on this scale, young people are isolated by a variety of factors. The current support via Medicaid-funded early childhood programs or community-based outreach could be erased with future cuts—leaving these youth behind.

Open to Change

Fractured Futures found that three out of four congressional districts have multiple high-risk factors for youth mental health, and at least 43 percent of Southern districts are labeled “Multi-Burden Districts.” As the name suggests, the people living in these districts must deal with intersecting, systemic challenges.

“We’re in a world that’s constantly changing, and new things are happening in the world that are affecting mental health.”

At the same time, Multi-Burden Districts are often in states that do not offer the kind of infrastructure that can provide a social safety net (such as Medicaid expansion). The residents of “Mississippi, Tennessee, and Alabama face especially high risk across all themes” (4).

There are also states that have already expanded Medicaid through the Affordable Care Act with trigger laws that would roll those protections back if Republicans’ latest efforts to dismantle ACA protections are successful. Indiana and Arizona are two such states. Their populations are described as having some of the “least resilient districts to absorb the fallout” (13).

In the House’s iteration of the “big, beautiful bill,” states that enroll children in Medicaid programs regardless of immigration status will be targeted, a provision that has already led some governors to roll back this part of their state healthcare exchange. The states that continue to choose to cover children or adults without documentation will be penalized with a reduction in matching funds from the federal government.

In general, these withdrawals of safety nets and access to care are out of step with what young people want and need.

As Jojo, a young Haitian American man in Massachusetts, told researchers at Youth Mental Health Tracker, “We’re in a world that’s constantly changing, and new things are happening in the world that are affecting mental health….There’s like a gap in that understanding, so I think adults as decision-makers, as policymakers, who have the ability to impact the world—I think it’s important to be open to change.”

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