By Stacy M. Brown
Black Press USA Senior National Correspondent
Millions of Americans are facing steeper barriers to mental health care as the Trump administration dismantles protections designed to hold insurers accountable. According to ProPublica, just months into his second term, the administration paused Biden-era rules that required insurers to disclose how they restrict or deny mental health claims. The suspension, combined with funding cuts to the federal agency that enforces mental health parity, has left patients vulnerable to denials, delays, and rising medical bills.
The timing is especially troubling. According to the 2024 Senior Report, drug deaths among U.S. adults 65 and older surged in recent years, with the District of Columbia experiencing a 120 percent increase between 2017-2019 and 2020-2022. The same report found that Black seniors across the country are more than four times as likely to die prematurely as their white peers. These outcomes point to the urgent need for accountability in coverage — precisely what federal regulators are now retreating from.
Oversight is rapidly shrinking. Various reports note that the Employee Benefits Security Administration (EBSA), the Labor Department agency responsible for enforcing parity laws, is expected to lose nearly 20 percent of its workforce, dropping from 831 employees in 2024 to fewer than 700 by 2026. The investigative staff alone has already been cut by almost 40 percent in some regions, forcing remaining investigators to juggle overwhelming caseloads and leaving families waiting longer for relief.
For many, the results are devastating. ProPublica detailed the case of a Massachusetts family whose teenage daughter developed self-harm behaviors and severe anorexia during the pandemic. Their insurer denied coverage for residential treatment, leaving the family with more than $80,000 in bills. Only after a long battle and intervention from an EBSA investigator did the insurer agree to repay most of the cost. With fewer investigators and weaker rules, similar families may not get help.
Researchers noted that local initiatives continue to show what is possible. CareFirst BlueCross BlueShield previously reported that it has invested nearly $8 million into behavioral health grants across Maryland, Virginia, and the District of Columbia. In the program’s first year, more than 3,300 youth were screened for unmet behavioral health needs, and thousands received clinical or peer support. CareFirst also says it funded the training and licensing of dozens of new providers to address shortages. Still, such community-driven programs, while impactful, cannot replace national oversight.
The rollback of mental health protections is part of a continuing trend. With all his devastating policies that come right out of the Project 2025 playbook, Trump has moved to unwind several Biden-era initiatives across health care, energy, and education. In mental health specifically, advocates warn that the administration’s actions have effectively gutted the strongest provisions of the 2008 Mental Health Parity and Addiction Equity Act, which was designed to guarantee equal treatment for mental and physical health care.
The consequences are already visible in communities nationwide. According to the 2024 Senior Report, racial and economic disparities in mortality, drug deaths, and housing insecurity continue to grow. Without federal enforcement to guarantee coverage, those inequities are likely to deepen. “The expectation was that these rules would be incredibly significant in driving better compliance,” former EBSA deputy Ali Khawar told ProPublica. “So now that it is on hold, it is a significant benefit that will never be realized.”
