In a dramatic U-turn, US health officials have begun reinstating nearly $2bn in funding for mental health and substance use programmes, just one day after announcing their immediate termination. The reversal follows intense public criticism and creates a significant setback for the agenda of Health Secretary Robert F Kennedy Jr.
A Swift Reversal Following Immediate Backlash
The US Department of Health and Human Services unexpectedly announced the sweeping cuts on Tuesday, which would have slashed programmes amounting to a quarter of the budget for the Substance Abuse and Mental Health Services Administration (SAMHSA). The decision prompted an immediate outcry from lawmakers, healthcare providers, and advocacy groups.
The proposed cuts targeted a wide range of critical services. These included overdose prevention and reversal initiatives, such as naloxone distribution, mental health support for children, training for first responders, programmes for pregnant and postpartum women, and recovery support networks.
By late Wednesday night, following what one official termed "national outrage," the department began backtracking. Some programmes received letters confirming their reinstatement, while others were left waiting for official notification that their work could continue.
Political Pressure and Public Advocacy Force Change
Democratic lawmakers were quick to condemn the initial decision. Representative Rosa DeLauro, ranking member of the House appropriations committee, stated that Secretary Kennedy had "bowed to public pressure" by reinstating the grants that "save lives." She emphasised that Congress holds the power of the purse and that the secretary must follow the law.
Washington Senator Patty Murray echoed the sentiment on social media platform X, criticising the "absurd, pointless chaos" caused by the announcement. She noted that first responders tackling the fentanyl crisis had spent the day planning layoffs instead of aiding those in need.
The reversal is seen as a direct blow to the policy goals of Robert F Kennedy Jr. In his first year, he has pursued aggressive, legally contested cuts across health agencies and has proposed folding SAMHSA into a new entity called the Administration for a Healthy America (AHA).
Uncertainty Remains for Future of US Health Programmes
While the reinstatement is a victory for service providers, experts warn that the underlying threat to public health funding persists. Dr Sunny Patel, a former senior SAMHSA official, noted that the administration has shown a "political project to systematically dismantle the behavioural health system."
Patel, writing in Health Affairs with colleague Matthew Biel, argued that the repeated uncertainty and cuts worsen outcomes, particularly for children's behavioural health. He concluded that safeguarding these essential services "requires vigilance and sometimes outrage," adding that the recent events prove "advocacy works."
The episode highlights the fragile state of key health programmes under the current administration. As budget negotiations in Congress continue, millions of Americans who rely on mental health and addiction services face an uncertain future, despite this temporary reprieve.
