Rhode Island Delegation emphasizes Medicaid’s role in supporting Behavioral and Mental Health
“Let me tell you as someone with a front-row seat," said Dr. Paul Wallace, "that my patients’ lives are incredibly precarious already, and my patients cannot afford to lose what little they have."
Senators Jack Reed and Sheldon Whitehouse joined Representatives Seth Magaziner and Gabe Amo at Butler Hospital on Tuesday, along with key medical professionals and advocacy groups, to emphasize how Republican-proposed cuts to Medicaid will harm Rhode Islanders seeking behavioral and mental health care and the providers who serve them.
Medicaid is the leading program that provides comprehensive care to millions of Americans, including more than 300,000 Rhode Islanders — including adults with disabilities, nursing home residents, children, mothers and newborns, and Medicare beneficiaries. In 2023, Rhode Island received $2.17 billion in Medicaid funding — accounting for 41 percent of all federal funding delivered to the Ocean State.
“The Providence Center is a certified community behavioral health clinic, which means we offer mental health and substance use services to any Rhode Islander who walks through our doors,” said Dr. Paul Wallace, Medical Director of The Providence Center. “We essentially act as the safety net for Providence in terms of mental health services, and we are the largest clinic of our kind in Rhode Island, serving nearly 9000 patients annually, approximately 70% of whom are on Medicaid. We offer a long list of services, including therapy, case management, psychiatric medications, crisis response, substance use treatment, and supportive housing, and we collaborate with many local partners, including Providence Fire and Police, Providence Public Schools, community health organizations like PCHC and Open Door Health, and every hospital in the state. It is our mission to serve the community in Rhode Island and especially Providence, and we are proud to be a cornerstone for mental healthcare in the state.
“I’m proud to serve as the medical director of The Providence Center, but it’s an even greater honor to be entrusted by my patients as their psychiatrist. My patients trust me to listen to their stories and help them live better lives, and they are why I am here speaking to you today. The life-changing mental health services we offer thousands of Rhode Islanders would be impossible without Medicaid, Medicare, and federal grants funded by our tax dollars. What better use of tax dollars is there than enhancing the health and wellbeing of our communities? Not only does defunding Medicaid mean defunding The Providence Center and every community clinic like it, but it means stripping poor, working-class, and middle-class Rhode Islanders of their health insurance and other sources of support that allow them to maintain a decent standard of living.
“Let me tell you, as someone with a front-row seat, that my patients’ lives are incredibly precarious already, and my patients cannot afford to lose what little they have. Most can barely afford their rent, utilities, and grocery bills, and they live in fear that they are *this* close to it all tumbling down. All of this fear and stress has been taking a devastating toll on my patients’ mental health, and in our current climate, mental health workers, and frankly all healthcare workers, are fighting an uphill battle. We are devoted to our work, but we are begging for your support. It is unbearable to watch our patients’ lives spiral due to factors outside of their control and ours, and so we turn to advocacy on their behalf.
“I know what I’ve already said should be enough to convince any decent Rhode Islander of Medicaid’s worth, that it is worth funding the program that provides access to mental health and medical services to a third of Rhode Island’s population and allows community behavioral health centers like The Providence Center to exist. But in case you need any more convincing, I’ll add one last warning based on my unique vantage point as someone who bears witness to my individual patients’ lives and also sees our healthcare system writ large. Defunding Medicaid will have deleterious effects that ripple throughout every corner of our state, far beyond Medicaid recipients. Not providing timely access to mental health services and substance use treatment means people will be turning up to hospitals in worse shape than ever. Police officers and firefighters will be responding to one mental health crisis after another. People will struggle to work and pay rent, will lose their housing, and end up on the streets. Children will drop out of school. Suicides and overdoses will increase. People will become sicker and die sooner from health conditions. Even if you yourself do not receive Medicaid, you will see the effects of Medicaid cuts in your community, and it will be heartbreaking.
“I don’t revel in sounding this alarm, but I do it as a favor to all of us before it’s too late. We must do everything we can to protect Medicaid and protect all Rhode Islanders.”
The Republican budget resolution directs specific committees to achieve spending cuts or increases. Republicans’ leaked menu of options includes:
At least $880 billion in cuts for the Energy and Commerce Committee could target Medicaid, Affordable Care Act (ACA) premium assistance, and repeal Inflation Reduction Act policies.
At least $330 billion in cuts are proposed for the Education and Workforce Committee, which could target student loan programs, income-driven repayment, Pell Grants, Head Start, and school lunches.
At least $230 billion in cuts for the Agriculture Committee could target SNAP.
Up to $4.5 trillion in new spending for the Ways and Means Committee, which could include tax cuts for the top one percent at the expense of average Americans.
“We are a consumer advocacy organization,” said Laurie Marie Pisciotta, Executive Director of the Mental Health Association of Rhode Island. “Our work increases access to behavioral healthcare in Rhode Island. I have lived with mental illness for much of my life.
“I am here today to make a heartfelt plea to our leaders to protect Medicaid funding for behavioral healthcare.
“When considering funding cuts, our leaders have to make tough decisions. They examine their priorities and analyze the costs and benefits of each item in the budget. Wise leaders, however, also take into account the long-term consequences of their decisions and the human toll.
“Today, we stand at a critical juncture. To save money, do we as a society turn our backs on the most vulnerable Rhode Islanders - those of low economic means, those who live with mental health or substance use disorders, those who are just getting on their feet again, trying to take care of themselves and their families? Do we let them fend for themselves, even if it costs them everything?
“No. We must show up for those Rhode Islanders. It is our moral duty to take care of each other, especially the most vulnerable among us.
“That is why it’s critically important to preserve funding for Medicaid. In Rhode Island, Medicaid is the single largest payer for behavioral health services, covering about a third of our population. It is the lifeline that sustains thousands of individuals struggling with mental health and substance use disorders. For many, it’s the only access to essential behavioral healthcare services. Cuts to Medicaid funding would be devastating, leaving vulnerable individuals without the crucial support they need to navigate their challenges. Imagine the impact on someone struggling with depression, an eating disorder, a bipolar condition, or addiction—the loss of therapy, medication, and peer support could push them further into crisis. I personally can’t imagine losing my therapist, who has helped me so much in my own journey.
“Over 300,000 Rhode Islanders would be affected by Medicaid cuts. About one in five adults lives with a mental health condition. We must remember the faces behind these numbers—they are our mothers, fathers, children, neighbors, and friends who rely on Medicaid for their mental and emotional wellbeing. The human cost of these cuts would be immeasurable. Without access to treatment, individuals’ conditions could worsen, leading to job loss, family breakdown, homelessness, and even suicide.
“Let’s not forget the ripple effect. Untreated mental health conditions and substance use disorders impact families, workplaces, and communities as a whole. A healthy population is a productive population. Investing in mental healthcare is an investment in our collective future.
“Beyond the human toll, cutting Medicaid would also be fiscally irresponsible. The short-sightedness of such cuts is clear when considering the increased costs associated with untreated mental illness and addiction. Emergency room visits and hospitalizations skyrocket when individuals lack access to preventative and ongoing care. The costs associated with these crises far outweigh the investment in preventative behavioral health services.
“We must make a choice: short-term budget savings at the expense of human suffering or a long-term investment in a healthier, happier, and more productive Rhode Island. The choice is clear. Invest in policies that support access to life-saving behavioral healthcare. Invest in Medicaid.
“Medicaid is not merely a government program; it’s a beacon of hope for millions. Diminishing Medicaid diminishes hope.”
Statements from the federal delegation:
“Taking health care away from people as Trump and the Republicans are talking about makes zero sense,” said Senator Jack Reed. “More than 306,000 Rhode Islanders rely on Medicaid. Republicans’ proposal to cut Medicaid so they can give more tax breaks to billionaires is a betrayal that would shift costs to families, states, and health systems that can least afford it.”
“Thanks to Medicaid, Rhode Islanders are able to get the mental health care and addiction treatment they need to lead productive, healthy lives,” said Senator Sheldon Whitehouse, a senior member of the Senate Finance Committee, which has jurisdiction over Medicaid. “As Republicans actively work to take away health care from millions of Americans, our delegation will fight to preserve Medicaid.”
"Right now, mental health care is under attack, with Trump, Musk, and House Republicans pushing reckless Medicaid cuts that could force hospitals to scale back services—just to fund tax breaks for billionaires,” said Representative Seth Magaziner. “Everyone deserves access to quality mental and behavioral health care, and Medicaid is key to making that possible. We’re fighting to protect it by any means necessary so Rhode Islanders can get the care they need.”
“If Republicans get their wish of cutting $880 billion from Medicaid, the harm would be astronomical. It would widen already large gaps in coverage and put those struggling with mental health and substance use disorders at even greater risk,” said Representative Gabe Amo, a member of the House Committee on the Budget. “Cuts to Medicaid will be felt everywhere. It will stress the availability of health services for everyone — including hospital systems, providers, community health centers, and school health programs who are already facing challenges.”
Other statements:
“Medicaid is the backbone of behavioral healthcare in Rhode Island, ensuring that thousands of individuals and families have access to critical mental health and substance use disorder services at hospitals and facilities with expertise and specialized training,” said Michael Wagner, MD, FACP, president and CEO, Care New England Health System. “Proposed cuts to Medicaid would have a devastating impact on Butler Hospital, The Providence Center, and behavioral health providers across the state, limiting essential care for those who need it most. Care New England stands with Congressman Amo and our congressional delegation in urging the protection of Medicaid funding to safeguard the wellbeing of our communities and preserve access to life-saving care.”
“At Butler Hospital, we see firsthand how vital Medicaid is in providing access to behavioral health care for Rhode Islanders in need,” said Mary E. Marran, MS, OT, MBA, president and COO, Butler Hospital; Chief Administrative Officer, Care New England Health System. “Proposed cuts to Medicaid would have a devastating impact on the vulnerable patients and their families who come to our hospital for help. I applaud Congressman Amo and our congressional delegation, who are our champions in advocating for the critical funding necessary to support mental health and substance use treatment services across our state.”