This solo episode features Rachel Harrison, host of Mental Health Evolution, exploring how rising out-of-pocket health care costs are reshaping access to therapy and mental health care in 2026.

Rachel examines national data, insights from practitioners, and lived experiences from clients to explain why costs and coverage patterns have shifted so dramatically—and what this means for the future of affordable, sustainable mental health care.

00:00 – Introduction and context
01:00 – Why 2026 is different
02:04 – Key articles and data sources
05:00 – Provider experiences and referral changes
07:40 – Deductibles, premiums, and co-pay increases
09:30 – Medicaid cuts and coverage loss
10:30 – Who gains and who loses
12:00 – APA recommendations and practical responses
13:00 – Creative solutions for access and affordability
14:30 – Closing reflections

1. Out-of-pocket costs are changing mental health access nationwide. Even insured clients are leaving therapy due to financial constraints.
2. Insurance structures are compounding affordability gaps. Deductible and co-pay increases are eroding real coverage value.
3. Clinicians are navigating new referral and revenue challenges. Practices are adapting to maintain viability amid shrinking access.
4. Documenting financial impact is critical for advocacy. Gathering data about cost-related care terminations supports system-level reform.
5. Creative, local solutions can help bridge care gaps. Partnerships, flexible scheduling, and funding programs can sustain access during economic strain.

Articles and Reports:

• The High Costs of Mental Health Care: A Barrier, a Burden, and a Call to Action — Access Institute
  https://pmc.ncbi.nlm.nih.gov/articles/PMC11786981/

• Insurance Design Can Create Co-Pay Barriers to Mental Health Care — RWJF
  https://www.rwjf.org/en/insights/our-research/2024/02/marketplace-pulse-differences-in-cost-sharing-create-barriers-to-mental-healthcare-in-medicare-advantage.html

• New Policies Affecting Access to Mental Health Care — APA Services 2026 Summary
  https://updates.apaservices.org/new-policies-affecting-access-to-mental-health-care

• High Out-of-Pocket Cost Burden for Mental Health Care — PMC Report (2024)
  https://pmc.ncbi.nlm.nih.gov/articles/PMC11786981/

Website: The Mental Health Evolution Podcast
Instagram: @mentalhealthevolution
LinkedIn: Mental Health Evolution
Facebook: Mental Health Evolution

Music by Zach Harrison