We wrote last month on this blog about our predictions for Trump’s second administration. The post covered Trump’s approach to behavioral healthcare in general, and recovery residence policies in particular.
It’s only been a few weeks, but so much has transpired at the Federal level that it seems like an update is in order.
The areas of focus in our previous post - changes or reductions to Medicaid funding, immigration policy ripple effects, shakeups in evidence-based care - they are all still relevant, but the list of possibilities continues to grow. As the Trump administration continues to make bold, quick-succession changes to the structure of the Federal government, agencies of particular interest to behavioral healthcare, like the Department of Health and Human Services and the Centers for Medicare and Medicaid, are due for some big shifts.
Today, we’ll speak on some of the most pressing questions sober living home owners and operators have about what’s on the horizon for behavioral health in 2025.
Are population specific services, like recovery residences for specific races, genders, and/or sexual orientations still a viable idea in 2025?
Population-specific care, also known as culturally competent care, has been touted as an effective approach for many populations by trusted behavioral health organizations like SAMHSA for decades. This trend has grown over the years, but is frequently characterized as an area in need of urgent growth to meet demand. We now see recovery residences designed to cater specifically for the needs of young men, women with children, male business executives, health care professionals, first responders, professional athletes, LGBTQIA individuals, and more.
While this trend has been hailed by many as a positive development in the behavioral health community, it is possible that some manifestations of this business model may not be compatible with Trump’s Executive Orders, namely “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government” and “Ending Radical and Wasteful Government DEI Programs and Preferencing.” These orders, and others in a similar vein, limit Federally recognized genders to two categories: “Men” and “Women.” They also eliminate any programs that demonstrate a “preference” for one group of people over other groups of people.
How these Executive Orders will be interpreted and implemented throughout the Federal Government is still an open question, with many of the details yet to be ironed out.
However, it does seem likely that recovery residence programs designed for the LGBTQIA community, in particular, will struggle to qualify for any federal funding - whether that’s funds coming directly from the federal government, or funds passing through state Medicaid programs, which are funded, in part, by the Federal government.
What are RFK Jr’s plans for recovery housing?
RFK Jr has a keen interest in recovery due to his own personal experience with addiction. He has stated many times that he credits the 12-step program with his long-term sobriety, and that he has strong doubts about the safety of pharmaceuticals used in the treatment of mental health and behavioral health conditions, including addiction treatment drugs like methadone and suboxone.
On his first day following his confirmation as head of Health and Human Services, RFK Jr released a statement on behalf of the HHS acknowledging the “biological truth” of there being only two genders. Should RFK seek to fully integrate that gender philosophy into behavioral healthcare in the United States, it seems likely that recovery residence programs designed specifically for the LGBTQ community, like this one in Portland, may not be able to expect Federal support moving forward.
What about MAT and pharmaceuticals used to deliver evidence-based addiction treatment? Will the rules on those change for recovery residences?
This is a tough question to answer. We know that RFK Jr has spoken at length about his open hostility to pharmaceuticals, particularly those used for behavioral and mental health conditions. We also know that in previous documents, Trump has omitted any mention of MAT when he discusses his 2025 vision for addiction treatment.
In the early days of his leadership at HHS, JFK Jr helped the White House release an executive order to establish the “Make America Healthy Again Commission.” This group will be looking closely at commonly prescribed medications for people with SUD, such as SSRI antidepressants, mood stabilizers, ADHD medication, and more. It seems likely that this entity will also examine the pros and cons of MAT medications, like Methadone and Suboxone.
In recent years, recovery residences have begun accepting patients with legitimate prescriptions for these medications. It’s an open question if recovery residences that rely on federal funding will be able to continue to work with patients who have access to all of these types of medications.
Will mental health parity continue unfettered under the second Trump administration?
Mental health parity is a central issue for most owners and investors in the behavioral health space. Without the mental health parity laws, as written, patients are not entitled to health insurance coverage for behavioral health conditions like SUD. This means that many organizations will lose clients who are covered under Medicaid and Medicare programs. For many addiction treatment providers, this would be catastrophic.
Those parity laws are currently being challenged in court. Because mental health parity laws are considered an industry regulation, and because Trump’s administration is famously anti-regulation, it is possible that mental health parity could become a thing of the past.
However, there’s hope, too, that RFK Jr’s cousin, Patrick Kennedy, will leverage the Kennedy Forum and his family relationships to champion mental health parity law.
Other blog posts on the Trump administration’s policies and plans that may affect sober living home and recovery residence operators
Predictions for Trump's Behavioral Health Policy for Recovery Residence Operators in 2025
Forecasting Trump's Behavioral Health Plan for Addiction Treatment Providers in 2025
2025 Federal Addiction and Mental Health Treatment Policies Under the Trump Administration Part 2
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