Dozens of leading behavioral health organizations are calling on Congress to expand and extend the Certified Community Behavioral Health Clinic (CCBHC) Medicaid demonstration program, which is currently set to expire on May 22. Their appeal highlights both the urgent need for comprehensive behavioral health services across the country and the effectiveness of CCBHCs in bridging treatment gaps for mental health and substance use disorders (SUDs).
In a letter issued by the National Council for Behavioral Health, more than 60 national and state organizations, including the American Psychiatric Association, the American Society of Addiction Medicine, the American Psychological Association, and the National Alliance on Mental Illness, urged lawmakers to act quickly. Specifically, they are advocating for a bill that would extend the program for two additional years and add 11 more states to the demonstration.
With bipartisan support, federal funding proposals, and increasing demand for services, many in the behavioral health community believe the expansion of CCBHCs is both necessary and achievable.
What Are CCBHCs and Why Do They Matter?
Certified Community Behavioral Health Clinics were created under the Excellence in Mental Health Act of 2014 as a demonstration program designed to increase access to coordinated, comprehensive care for individuals living with mental health and substance use challenges.
Unlike traditional community clinics, CCBHCs are required to provide a wide array of services, including 24/7 crisis intervention, outpatient mental health and substance use disorder treatment, medication-assisted treatment (MAT) for opioid and alcohol use disorders, case management and care coordination, primary care screening and monitoring, and collaboration with law enforcement, schools, and hospitals.
In exchange for providing this expanded scope of services, CCBHCs receive enhanced Medicaid reimbursement rates. This allows them to hire more staff, pay competitive wages, expand outreach, and serve more individuals—particularly those who are underinsured or uninsured.
The model has been praised for its ability to reduce barriers to treatment, provide whole-person care, and strengthen the behavioral health safety net.
What’s at Stake If the Program Expires?
Without congressional action, the CCBHC Medicaid demonstration could end in May, potentially leaving thousands of vulnerable individuals without access to lifesaving services. According to the National Council for Behavioral Health and other advocates, nearly 9,100 patients could lose access to medication-assisted treatment (MAT) for opioid use disorder, thousands more would face longer waitlists or be turned away from care altogether, and more than 3,000 clinicians could lose their jobs, threatening the stability of an already strained behavioral health workforce.
The expiration of the program would have ripple effects across communities. Law enforcement agencies, schools, and hospitals that rely on CCBHC partnerships could also lose critical support. In a time when the opioid epidemic and rising rates of suicide remain national concerns, behavioral health leaders argue that ending the demonstration would be catastrophic.
Growing Bipartisan Support
Despite the looming expiration date, advocates remain optimistic. Congress has already extended the demonstration six times since March 2019, signaling broad support for its continuation.
The Trump administration’s budget proposal for fiscal year 2021 further underscores this momentum. The proposal allocates $906 million to extend and expand the CCBHC Medicaid demonstration while also setting aside $225 million in CCBHC expansion grants. These grants allow states not currently participating in the demonstration to begin building their own CCBHC models with two years of capped federal funding.
This funding commitment reflects recognition of the program’s value, not only from policymakers but also from the general public. Polling data released by the National Council in conjunction with its letter to Congress shows that 82% of voters support increasing federal funding for mental health and addiction treatment. That overwhelming public backing adds pressure for lawmakers to act.
Why Expansion Is Necessary
Currently, only eight states participate in the CCBHC Medicaid demonstration. Advocates are pushing for the program to expand to 11 additional states, citing the urgent need for equitable access to behavioral health services nationwide.
Expansion is crucial because it widens access to care, as millions of Americans with mental health or substance use disorders live in areas with limited services. It helps address workforce shortages since higher Medicaid reimbursement rates make it easier for clinics to recruit and retain qualified providers. It improves health outcomes by reducing hospitalizations, improving treatment adherence, and providing continuity of care. Finally, it reduces community burdens by strengthening collaboration with schools, law enforcement, and hospitals.
Behavioral health leaders stress that expanding the program is not just about funding clinics—it’s about ensuring stability, accessibility, and better outcomes for patients and communities.
Looking Ahead
While the immediate goal is to extend the demonstration for two years and expand it to additional states, the long-term vision is to make the CCBHC model available nationwide. National Council CEO Chuck Ingoglia highlighted this in his press release, noting that bipartisan leadership will continue to be critical in moving toward that goal.
“Bipartisan congressional leadership has made this important progress possible and will continue to be essential if we are to achieve the long-term goal of extending CCBHCs nationwide,” Ingoglia stated.
The push for expansion comes at a time when demand for behavioral health services is increasing, particularly due to the opioid crisis and rising suicide rates. By strengthening the infrastructure of community-based care, CCBHCs have the potential to transform behavioral health systems across the country.
Conclusion
The call from behavioral health leaders to extend and expand the CCBHC Medicaid demonstration reflects both the urgency of the nation’s behavioral health crisis and the proven effectiveness of the CCBHC model. With bipartisan support in Congress, a strong commitment from the Trump administration, and overwhelming public approval, the chances of an extension appear strong.
If expanded, CCBHCs could provide thousands more Americans with access to comprehensive, coordinated care—bridging treatment gaps, supporting communities, and saving lives. If allowed to expire, the country risks losing a vital program that has already made measurable strides in addressing the behavioral health needs of some of its most vulnerable populations.
The next few months will be critical, as lawmakers weigh the future of CCBHCs and their role in strengthening the behavioral health system. For patients, providers, and communities, the stakes could not be higher.
