A Tale of Two Behavioral Health Systems, or How the State Border Determines Who Gets Access to Mental Healthcare

The One Big Beautiful Bill Act (OBBBA) led to Medicaid and CHIP cuts, causing 1.59 million Americans to lose insurance by April 2026, with 13 million more projected to lose coverage. Becky Wolery's Oregon-based clinic, Insight Matters, lost Medicaid eligibility in December 2025, threatening access to care in Malheur County, a healthcare desert with high Medicaid enrollment. State border differences, such as between Oregon and Idaho, created disparities in Medicaid impacts.