Medicaid Cuts Put Oklahoma Mental Health Community in Tough Place

The state's mental health providers are dealing with the doubly whammy of reduced funds and the lingering effects of the government shutdown

Access to mental health care can make a huge difference in someone's well-being and recovery. Recent cuts have impacted Oklahoma mental health providers' ability to serve patients. Photo credit: Joshlyn McKey.

For millions of Americans, access to health care can determine stability or crisis, and Medicaid often serves as the program that makes that care possible.

As a federal-state program, Medicaid provides coverage for children, low-income adults and individuals with disabilities, delivering the help people need when gaps are left by private insurance. Mental health services are experiencing a rising demand and Medicaid has stepped in as the leading provider, often determining who receives care and how quickly. 

However, recent legislation threatens this critical support. On July 4th, President Donald Trump signed the One Big Beautiful Bill Act into law, limiting the funds allocated to Medicaid and imposing heavy restrictions on its resources and access.

The Kaiser Family Foundation estimated that the federal budget, which codified the Medicaid cuts, would reduce program spending by $911 billion nationwide. 

 “Medicaid is the backbone in that sense,” said Randi Vinson, a medical care coordinator for Family and Children’s Services. Vinson explained that employment alone isn’t always enough to sustain someone, and cutting off Medicaid prevents people from receiving the vital resources that they need. “That’s obviously going to affect their mental health.” 

Vinson manages a diverse range of clients, addressing everything from medical concerns such as substance abuse, homelessness and mental health diagnoses to financial and budgeting support. 

“A lot of the misconception is, oh, well, mental health is just talking to people. No, it's not. It's physical, mental, emotional, financial, psychological, it's all of those. It's a realm of wellness… Those play a part in holistic overall being,” she said.

Medicaid plays a huge role in the scope of support Vinson and her team can provide. In one case, a client came to them with unmet medical, vision and dental needs. When the individual was not initially enrolled in Medicaid, the team assessed eligibility factors such as income, assisted with the application process and consistently advocated on the client’s behalf. Ultimately, they helped connect the individual with a primary care physician, optometrist and dentist. Addressing these health needs not only improved the client’s well-being but also had a positive ripple effect on their children, friends and people they interacted with daily. 

Reiterating the significant role of federal support, Marti Duggan, the director of Student Support Services for Epic Charter Schools, emphasized the gravity of Medicaid and similar programs: “If there’s a word bigger than ‘of crucial importance,’ I don’t know what that word is.”

Duggan serves as Epic’s homeless liaison, identifying and supporting students without adequate caregivers and families facing financial hardship. She and her teams coordinate across multiple microsites to distribute winter coats, clothing, hygiene products and school supplies.

“We help with food and security, lack of medical care, unsafe housing, transportation, clothing, really whatever the need they have they bring to us, we start addressing it. The way we do that is we collaborate with local agencies and state agencies who have those supports.”

According to Duggan, collaboration with student wellness allows mental health and school counseling services to reach all 77 counties, ensuring that lack of insurance or financial resources does not prevent families from receiving care. 

Much of Duggan’s role centers on how she responds when she or a student encounters a barrier. “Being an educational agency, we have limited power in some sense. For example, if a family is uninsured and they need medical treatment, Epic doesn't provide the actual medical treatment. We provide the resources to get there. If the resources or the funding is cut or severely limited, then our ability to even direct family to resources is severely diminished.”

She added: “The more funds we have, the more access we have, the more families we can help."

Along the same lines, Vinson said that if given the opportunity to speak with policymakers, she would advocate for increased resources.

“They could be doing more for these places, for the salvation armies, for people that are homeless," she said.

Vinson said she treats each person who comes to her not as a client but as a member of her family. She ensures that the care she provides is the same care she’d want if she were on the other end. She expects the same familial views to be implemented by policymakers.

“Everybody knows what it could look like to be homeless because we see that every day as we get in our cars and go to where we're going. Or we can walk outside of a house and see somebody that is homeless. Just to have better resources and better tools for us to utilize and for the community in general to utilize. Just making better decisions on the funding and how they're allocated and how much is allocated," she said.

Shutdown's impact continues

While last fall's government shutdown did not directly cut Medicaid funding, it did intensify the effects of Medicaid policy changes by disrupting related support systems. When these disruptions overlap, families face a compounded crisis.

Duggan explained that although partial funding has since been restored, it has not resolved the crisis many families continue to experience. The payments covered only a fraction of what previously supported an entire month, leaving ongoing gaps even after the government shutdown ended. In Oklahoma, childcare subsidies — particularly essential for teenage parents attending school — were also disrupted.

“On November 1st, when the benefit ceased, they started charging per day, per child in that childcare. So, something that used to be taken care of, even though it was a small incremental charge, was a big deal because it was everyday until the government opened back up and resumed their normal processes.”

The Licensed Child Care Association of Oklahoma has sued the state over the lapsed subsidies. DHS has said it could no longer afford to continue the program.

Vinson said that Family and Children’s Services and similar local organizations are always expected to fill the gaps that federal or state programs leave behind.

“When the government shut down, when people weren't getting food stamps, they didn’t understand the things that we have on the back side of it. Meaning, we have to make sure these clients that we have, or the community that we're reaching out to for help, still have enough product or whatever it is that they need," she said.

She explained that funding cuts often meant they were only able to intervene in cases involving significant or critical events. “With those cuts, there's no good in it, if you ask me, obviously, because we're not able to serve our clients the way they need to be served," she said.

Each situation is handled on a case-by-case basis. While there may be dozens of clients reaching out at once, the team must prioritize needs. This does not diminish the validity of any request, but limited resources require careful decision-making. Through collaboration, community support, and problem-solving, the team considers what options are available and who they can reach out to for assistance.

“Even if we weren't able to provide financial assistance, we could still advocate for them, which in terms could help their financial situation," she said.

According to Vinson, the most important aspect of her job is the outreach.

Counseling and rehab are both essential to the operations but outreach provides resources to an individual that those areas can’t. The community partners fill the gaps that Family and Children’s Services are unable to fulfill alone. While not in the same capacity as before, their partners offer sustainability and reliability to the clients, creating connections and relationships that wouldn’t have otherwise happened without those financial deficiencies. 

“The key is always collaboration because we can always do more together than we ever can alone,” Duggan said.

However limited, lacking the necessary funds from Medicaid doesn’t stop Vinson or Duggan from providing the rehabilitation, therapy, education and resources that somebody needs. The moment that vital revenue reaches a roadblock is when heart, intentionality, and community step in to meet vulnerable people where they are at. 

Because Family and Children’s Services is federally funded as a Certified Community Behavior Health Clinic, “anybody can walk through the doors regardless of their social economic status. Meaning they can make $1,000 or make $2 billion… we're going to see them and assist them no matter what,” Vinson said. 

Duggan said less money meant less ability to plan ahead to meet people's needs.

“Instead of being reactive all the time, try to be proactive when you can. So, for example, we know that families need coats for every single winter, but we don't start collecting coats in winter. So, it's collecting and getting resources ready so that when there's a need, we have them in response as opposed to reacting and having a gap in services. It's a constant balance of knowing what our families need and anticipating what they might need next,” she said.

Losing a large portion of the funding that supported individuals and families each day was deeply challenging. Yet through preparation, creative problem-solving and a shared commitment to the people they serve, Epic Charter Schools and Family & Children’s Services continued showing up and meeting needs, even in the face of uncertainty.