2025 Medicaid Cuts Effect on Substance Use Intervention and Treatment

The “One Big Beautiful Bill Act” passed by congress will negatively impact substance use disorder (SUD) intervention and treatment. The Affordable Care Act (ACA) will be dismantled, state grants will be eliminated, and a streamlined enrollment process will be terminated. Vulnerable populations will experience more significant losses of insurance coverage in general and greater upticks in SUD-related mortality specifically. This is due to these populations relying on Medicaid for both overall and behavioral health care at a higher-than-average rate. Currently, research is limited on the relationship between SDoH and Medicaid’s effect on SUD intervention and treatment. Furthermore, there exists almost no concrete research on the impacts that Medicaid cuts will have on this population’s access to SUD care. This literature review examines the relationship between SDoH, Medicaid access, and their impact on SUD interventions. The review also outlines the projected harms this bill will have on interventions as well as offer recommendations on preventative methods and future research. Finally, recommendations on the appropriate action to take towards reversing Medicaid cuts and future research to document this bill’s damage are discussed.