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OBBBA's State-Directed Payment Caps will Trim Some States' Medicaid Spend by a Quarter

Upcoming statutory limits on providers’ state-directed payments (SDPs) are expected to trim tens of billions of dollars from states’ Medicaid spending, and for 17 hard-hit states could range from 10% to 25% of their total annual Medicaid spending, according to a newly published analysis warning of subsequent reductions in care access. The latest effort to quantify the fiscal impacts of 2025’s One Big Beautiful Bill Act (OBBBA) on healthcare payments, published today in Health Affairs, leans on the Centers for Medicare and Medicaid Services’ (CMS’) approved SDP applications from 2024 and 2025. It does not include the impacts of “uncertain” provider tax changes also required by the law, or those of a pending proposal from CMS to expand the SDP limits beyond four types of services outlined in the OBBBA—both of which the study’s authors said would compound upon their estimates.  Still, the analysis outlined an estimated $51.8 billion reduction in annual Medicaid spending across 36 states (including seven non-expansion states) paying providers at or around (90% to 100%) average commercial rates from the 2024 levels. 

 

Trump Administration Issues Interim Enforcement Roadmap for Mental Health Parity Law

The Trump administration today released guidelines on renewed enforcement efforts under the Mental Health Parity and Addiction Equity Act (MHPAEA), after halting enforcement of the law in 2025.  

The latest guidelines are not the administration’s revised parity law, but rather a framework for enforcement action and identifying red flags during the interim.

A Sept. 8 bulletin from the Assistant Secretary for the Department of Labor’s Employee Benefits Security Administration (EBSA), Daniel Aronowitz, describes the agency’s intent to more substantially enforce the parity law’s nonquantitative treatment limitation (NQTL) requirements, which resulted from collective industry feedback.

 

SUD COE Kratom Trainings 

Kratom (Mitragyna speciosa) has rapidly evolved into a complex public health challenge across Ohio, linked to over 200 unintentional overdose deaths in recent years. As high-potency extracts and synthetic derivatives proliferate in retail settings, multidisciplinary healthcare and behavioral health teams must equip themselves with clear, evidence-based approaches to identify and manage clinical risks.

Join The Ohio Substance Use Disorders Center of Excellence for a practical, 90minute interactive training designed to give clinicians, social workers, counselors, nurses, physicians and first responders increased knowledge and understanding of Kratom.

Key Training Topics & Takeaways:

  • Pharmacology & Health Impacts: Differentiate dose-dependent mechanisms— from mild stimulant effects to opioid-like sedation, organ toxicity, physical dependence, and severe withdrawal at higher doses.
  • Exploring Myths vs. Facts: Separate dangerous retail misconceptions from clinical realities regarding product purity, addiction potential, and drug-drug interactions.
  • Behavioral Health Intersections: Understand the dynamic of self-medication for chronic pain, anxiety, and depression. 
  • Ohio Regulatory Framework: Become familiar with recent regulatory rules classifying synthetic Kratom 7-OH derivatives as Schedule I controlled substances.

Available Training Dates & Times: Click or Scan to Register!

Click here to view the event flyer and to register!

 

Your Voice Belongs at the Table: Join a NAMI Ohio Regional Listening Session

NAMI Ohio is pleased to formally invite you to our Mental Health Advocacy Listening Session for the Central Region on September 15 at the Wolfe Park Shelterhouse in Bexley.

This will be the first of five regional listening sessions held across Ohio as we introduce our “Blueprint for Mental Health in Ohio” and hear directly from communities about the challenges, needs, and priorities shaping Ohio’s mental health system.

We hope to bring together a broad group of voices from across the Central Region, including legislators, local officials, providers, community leaders, advocates, and individuals with lived experience. We encourage you to share this invitation with other decision-makers and community members you believe would benefit from being part of the conversation.

Mental Health Advocacy Listening Session – Central Region
September 15, 2026
11:00 a.m.–1:00 p.m. (Lunch provided)
Wolfe Park Shelterhouse – Bexley
105 Park Drive, Columbus, OH 43209

During the session, NAMI Ohio will present the “Blueprint for Mental Health in Ohio,” developed by a working group of providers, mental health experts, and individuals with lived experience. The Blueprint identifies five key priority areas that will guide our advocacy during the upcoming 137th Ohio General Assembly as we work toward a system that better serves Ohioans living with serious and persistent mental illness.

Just as importantly, we want to hear directly from you about the challenges facing your community, the needs you are seeing locally, and how these priorities can best support Ohioans living with mental illness.

Please register here to RSVP.

We hope you will join us for this important conversation. If you cannot make the Columbus event, feel free to join another session; see this link with more details: https://namiohio.org/nami-ohio-regional-listening-sessions/Please feel free to reach out to me with any questions or suggestions about others who should be included. Click here to view the event flyer with the other listening session dates!

 

Congress Clears Funding Patch to Avert Pre-Election Shutdown

The House cleared a stopgap funding patch Tuesday to keep cash flowing to federal agencies until mid-December — preventing a government shutdown before Election Day and setting up two major policy battles at year’s end.

The 370-48 vote takes care of Congress’ last must-pass bill before the midterms. The legislation would fund the government beyond the October start of the new fiscal year, keeping federal agencies running on current budgets through Dec. 11.

It also allows incumbents to campaign for reelection without the threat of a government shutdown feeding into political messaging about dysfunction in Washington. Besides funding the government through mid-December, the bill would temporarily block the White House from finalizing a rule to put political appointees in charge of approving federal grants. It would also delay a ban set to kick in next month on intoxicating hemp products — to the dissatisfaction of House hard-liners, who threatened to vote Tuesday afternoon against teeing up debate on other bills this week and potentially block any significant House floor action between now and November.

 
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