尽管唐纳德·特朗普总统长期以来一直试图将大规模枪击事件与精神健康问题联系起来，但他同时提出了将从美国最大的行为健康服务支付者医疗补助计划中削减数千亿美元的预算。
正如他在过去的大规模枪击事件后所做的那样——例如加州千橡树枪击案11月；这佛罗里达帕克兰枪击案2018年2月德克萨斯州萨瑟兰温泉例如，2017年11月——特朗普周一在谈到周末发生的两起杀人狂潮时指责精神疾病。
尽管特朗普此前承诺不会削减医疗补助项目的资金，但自上任以来，他一直试图在预算提案中大幅削减医疗补助项目的资金。今年3月，他提议削减预计的近1.5万亿美元医疗补助支出。
这凯撒家庭基金会说2015年，医疗补助“覆盖22%非老年人患有精神疾病的成年人和26%的非老年人患有严重精神疾病的成年人。“削减该计划将显著影响美国人的精神健康覆盖面。
国家精神健康联盟的代理国家倡导和公共政策主任珍妮弗·斯诺说，医疗补助是“任何关于精神健康护理的谈话中最关键的部分”新闻周刊。"它是美国精神健康和药物滥用服务的最大支付者."
特朗普政府还允许各州对寻求医疗补助的个人实施工作要求，进一步抑制了他们获得精神卫生保健的机会。
尽管白宫允许资格要求作为一种帮助方式人找工作——这种说法在最近的从…学习新英格兰医学杂志——预算和政策优先中心(CBPP)表示，特朗普允许资格要求的决定将伤害精神病患者。虽然被认为“身体虚弱”的人可以免于工作，牛触染性胸膜肺炎称这一定义排除了“许多有精神健康状况的人”其他一些人可能难以证明他们有资格获得豁免。
“不幸的是，特朗普政府已经批准了各州限制医疗补助资格的请求，限制方式主要针对有认知障碍的个人，例如将工作要求作为入学条件，”丽贝卡国家委员会负责政策和宣传的副主席法利·大卫告诉记者新闻周刊通过电子邮件。
此外，特朗普提议的条款破坏了《平价医疗法案》的一些重大扩展。他推动加强短期有限期限计划，这些计划通常不提供精神健康疾病的保险，这可能会影响到因美国反腐败协会扩大医疗补助而得到改善的精神健康保险。
“特朗普政府已经扩大了短期保险计划，这些计划不需要涵盖精神卫生保健，通常会将患有以下疾病的人排除在外pre凯泽家庭基金会负责健康政策的执行副总裁拉里·莱维特告诉记者新闻周刊在邮件里。
特朗普的提议并不总是试图削减对精神健康项目的资助，但与他追求的医疗补助削减相比，他提出的增加额显得苍白无力。他在2020财年的要求是增加115美元百万致药物滥用及精神健康服务管理局(SAMHSA)程序。
但是这个提议仅仅是将资金“增加了几分”SAMHSA同时掏空医疗补助，”斯诺说。
TRUMP HAS TRIED TO SLASH FUNDS FOR MENTAL HEALTH CARE DESPITE POST-SHOOTING RHETORIC
While President Donald Trump has long attempted to link mass shootings to mental health issues, he has simultaneously proposed budgets that would strip hundreds of billions from Medicaid, the country's largest payer of behavioral health services.
As he has done after past mass shootings—for example, the Thousand Oaks, California shootingin November; the Parkland, Florida shooting in February 2018 and the Sutherland Springs, Texas shooting in November 2017, for example—Trump blamed mental illness during his remarks Monday about two killing sprees that occurred over the weekend.
Yet Trump has sought to slash vast amounts of money from Medicaid in his budget proposals since taking office, despite previously promising not to cut the program's funding. In March, he proposed slashing almost $1.5 trillion from projected Medicaid spending.
The Kaiser Family Foundation said that in 2015, Medicaid "covered 22 percent of non-elderly adults with mental illness and 26 percent of non-elderly adults with serious mental illness." Cuts to the program would significantly impact mental health coverage available to Americans.
Medicaid is "the most critical part of any conversation about mental health care," Jennifer Snow, the acting National Director of Advocacy and Public Policy at the National Alliance for Mental Health, told Newsweek. "It's the nation's largest payer for mental health and substance abuse services."
The Trump administration has also permitted states to impose work requirements for individuals seeking Medicaid, further inhibiting access to mental health care.
Although the White House has permitted eligibility requirements as a manner of helping people get jobs—a claim that appears dubious after a recent study from the New England Journal of Medicine—the Center on Budget and Policy Priorities (CBPP) has said that Trump's decision to allow eligibility requirements will harm those with mental illnesses. While individuals considered "medically frail" are exempted from working, CBPP said that this definition excludes "many people with mental health conditions." Some others could have trouble proving that they qualify for an exemption.
"Unfortunately, the Trump Administration has approved states' requests to limit Medicaid eligibility in ways that fall particularly heavily on individuals with cognitive difficulties, for example by imposing work requirements as a condition of enrollment," Rebecca Farley David, the National Council's Vice President of Policy and Advocacy, told Newsweek by email.
Additionally, Trump has proposed provisions that undermine some of the significant expansions of the Affordable Care Act (ACA). His push to enhance short-term limited duration plans, which often don't provide cover for mental health illnesses, can impact mental health coverage that was improved by the ACA's expansion of Medicaid.
"The Trump administration has expanded short-term insurance plans, which are not required to cover mental health care and typically exclude people with pre-existing conditions, including those with serious mental illness," Larry Levitt, the Executive Vice President for Health policy at the Kaiser Family Foundation, told Newsweek in an email.