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Blaire Bryant

Legislative Director, Health | Large Urban County Caucus
Naomi Freel

Naomi Freel

Legislative Associate

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Advocacy

County Countdown – Dec. 15, 2025

County Behavioral Health Landscape

America’s 3,069 counties are integral to America’s behavioral health system. Counties annually invest over $130 billion in community health systems, including behavioral health services. Through 750 behavioral health authorities and community providers, county governments plan and operate community-based services for persons with mental illnesses and substance use conditions. County-based behavioral health systems exist in 23 states that represent 75 percent of the U.S. population.

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Advocacy

CMS requires state Medicaid suspension upon arrest versus termination

Effective January 1, 2026, federal law now requires states to suspend, rather than terminate, Medicaid coverage when an individual is incarcerated.

County Countdown
Advocacy

County Countdown – Dec. 15, 2025

Every other week, NACo's County Countdown reviews top federal policy advocacy items with an eye towards counties and the intergovernmental partnership.