02/24/2026
As the nation prepares to listen to the State of the Union, Thresholds wants to share what we’re seeing on the ground: policy instability is destabilizing mental health care and housing—and people living with serious mental illness and substance use conditions pay the price.
Over the past year, sudden federal actions—a federal funding freeze, funding changes for supported housing, policy shifts away from Housing First and towards criminalization of homelessness, sudden cancellation of substance use and mental health grants, and legislative changes threatening Medicaid and SNAP benefits—have created uncertainty for providers, staff, and clients.
Even when reversed through advocacy or court intervention, the unpredictability undermines continuity of care and fuels fear for people who rely on stable services and housing.
Medicaid remains the primary payor for behavioral health care. Proposed changes in H.R. 1 could lead to 500,000 people in Illinois losing coverage; as many as 4,000 Thresholds clients who rely on Medicaid Expansion could be at elevated risk. And because many households depend on both Medicaid and SNAP, many can face compounding hardship all at once.
Housing is health care. In Illinois, federal Continuum of Care funding supports 330 grants totaling $182M, including rental assistance for 21,400 people in permanent housing and 27,000+ emergency and transitional shelter beds statewide. Thresholds operates nearly 450 CoC-funded units—and without rental assistance, many clients living on fixed disability incomes face avoidable returns to homelessness.
What we need now: stability, predictability, and continued investment in evidence-based mental health services and supportive housing that work.
