Mental health providers in Idaho face significant challenges in stabilizing severely mentally ill patients following substantial cuts to Medicaid funding for critical behavioral health programs. The reduction, which took effect in December 2023, impacted essential services such as Assertive Community Treatment (ACT), a program long utilized to support individuals with serious mental illnesses, including major depression.
ACT had been instrumental in providing personalized care to patients in their homes and communities. However, funding cuts have severely limited these services, leaving many providers unable to meet the needs of their clients. According to Sara Bennett, a clinician based in Lewiston who managed the regional ACT program, the absence of financial support for community-based medical treatment has had dire consequences.
Bennett highlighted that the lack of reimbursement for a dedicated nurse has led to at least two patients falling weeks behind on their anti-psychotic medications. “We spent a year and a half stabilizing them. And now they’re both very much unstable and their symptoms are very significant,” she stated. The situation has escalated to the point where some former ACT patients have required hospitalization due to deteriorating conditions.
The cuts have also affected potential referrals from county jails and mental health courts, further straining the system. Bennett noted that approximately one-third of the former ACT patients her team served can no longer access any services, while another third experience inconsistent care. “It’s really inconsistent, not nearly as regular as it had been,” she remarked.
The broader implications of these funding reductions are profound. The Idaho Association of Community Providers (IACP) estimates that cuts to behavioral health programs could cost local taxpayers more than $150 million. This financial burden is expected to fall heavily on homeowners in cities such as Boise, Lewiston, Idaho Falls, and Pocatello.
Ric Boyce, co-director of IACP and former ACT team administrator in Pocatello, expressed deep concern about the fiscal impact on local communities. “For local taxpayers footing the bill for increased emergency care, we are looking at between $200 and $800 per person, per year,” he shared. Boyce also pointed to rising health risks among clients, noting that one former ACT patient died due to complications from routine medical care that could have been addressed with early intervention as part of the ACT program.
“We would’ve had multiple team members with eyes on that person. We would’ve identified that they needed medical care. We would’ve sent out our nurses as part of ACT,” he explained. The loss of this comprehensive approach has critical ramifications for patient health outcomes.
As the impact of Medicaid cuts becomes increasingly apparent, facilities such as the Behavioral Health Crisis Centers in Idaho Falls and Pocatello have reported a dramatic rise in client visits. According to a news release from Rehabilitative Health Services, these centers experienced a 34% increase in visits in December compared to the previous year, followed by a 43% increase in January 2026.
Amid these challenges, Bennett and Boyce have been actively engaging with legislators in hopes of restoring funding for ACT and other vital behavioral health services. Their advocacy underscores the urgent need for effective mental health support systems in Idaho to prevent further deterioration of patient care.
The situation highlights a critical intersection of health care policy and community well-being, raising questions about the long-term consequences of funding reductions on vulnerable populations. As the conversation surrounding mental health continues, the experiences of providers and patients in Idaho serve as a poignant reminder of the need for comprehensive support systems in the realm of mental health care.
