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Americans on Medicare now get better access to mental health care. Here's how
A new law brings in changes for mental health patients and providers.
Christophe Archambault/AFP via Getty Images
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Christophe Archambault/AFP via Getty Images
A new law brings in changes for mental health patients and providers.
Christophe Archambault/AFP via Getty Images
Starting Jan. 1, the more than 65 million Americans who rely on Medicare will have better access to mental health coverage.
Medicare now covers therapy appointments with licensed marriage and family counselors, and licensed professional counselors. These are two types of therapists who make up around 40% of the Master’s level mental health providers in the country, according to the American Counseling Association.
Victoria Kress, a professor at Youngstown State University and a licensed professional counselor, spoke with All Things Considered host Juana Summers about how this new law could affect patients and providers.
This interview has been lightly edited for length and clarity.
Interview highlights
Juana Summers: This seems like a bit of an obvious solution to me, I have to say. There’s a big group of people out there who need access to mental health care — and by that I mean Medicare recipients — and there’s another big group of providers who are able to do so. So why did it take so long do you think for this law to pass?
Victoria Kress: There have been many iterations of licensure and legislation that have been put forward, and many different legislative techniques and strategies that have been applied to try to get us at the table and to get this passed.
I think it was really money. When I would sit with legislators, the first question they would would ask is, “What is this costed out as? How is this going to impact us fiscally?” Obviously, when you have easier access to care and more people providing services, that’s going to increase the cost.
I think with COVID, with the pandemic, it really put a spotlight on mental health needs. And many people started to realize how critically important access to care is around mental health issues. And because of that, I think legislators felt an increasing pressure to provide access to care for those on Medicare.
Summers: We should just be frank here. The need for mental health care in this country is incredibly stark. The Department of Health and Human Services estimates that 169 million Americans are living in an area with a mental health provider shortage. So how much of a dent could this change make in what seems like massive need?
Kress: It’s profound. Yes, about half of America lives in an area with a severe shortage of providers. And I can tell you, as someone who works in an urban area, even in the urban areas they’re really walking the line and struggling to find enough providers to meet the demand for our services.
So 18% of Americans receive Medicare, and they’re going to overnight have access to so many more providers. So it’s really exciting, particularly when you think about the rural areas, where one in three people receive Medicare services, and there’s such a severe shortage of providers, it’s really going to be helpful to them.
Listen to All Things Considered each day here or on your local member station for more interviews like this.
Something else that we also don’t think a lot about is addictions. Many people in America struggle with addictions. Many older adults and people with chronic disabilities struggle with addictions. About a third of all inpatient hospitalizations for opioid use disorder are paid for by Medicare. And counselors are the primary provider of all addictions counseling services. So it’s been so difficult for people to access addictions care. And now with counselors being able to provide the services that we’re trained to provide, it’s really going to open up opportunities for people to access addiction services as well.
Summers: Medicare reimbursement rates are significantly lower than what many therapists can charge out of pocket. I mean, a single session can cost hundreds of dollars for in demand providers. Are you concerned that even though they’re able to, counselors now might not want to accept Medicare because of the lower payment rates?
Kress: Yeah, absolutely. And also with the legislative change, counselors, marriage and family therapists will be being paid about 75% of what a psychologist would make. And so that’s also a deterrent there.
So it’s going to be an ongoing issue to try to get providers to sign up for Medicare reimbursement. But you know, we also have challenges in terms of continuing to encourage people to go into the mental health helping professions. And educators have a responsibility to continue to pull folks in and to train them to meet the demand that’s out there. Counseling is actually one of the most needed professions right now, there’s a severe shortage all over the country.
Summers: I want to acknowledge here before I ask this question that, of course, senior citizens are not the only Medicare recipients, though they do make up the vast majority of that population. And we know that their mental health care needs are complex and seniors have faced obstacles to receiving mental health care for years. To what degree do you think that Medicare coverage from professional counselors and family therapists could help bridge the gap for that specific population?
Kress: Counselors are uniquely trained to meet the needs of older adults. As counselors, we receive training and counseling for people across the lifespan. But we’ve not been able to work with older adults, despite our training, because of difficulties with Medicare reimbursement. So this is really exciting.
One of the things that makes counselors unique from other mental health professionals is that we have a focus on mental health. And what that means is we focus on people’s strengths, their resources and their capacities within themselves, within their families, within their communities and within society. And we focus on those and we pull those into our treatment plans and how we go about helping them make the changes that they want to make.
So I think our focus on developments, our focus on mental health, our focus on being holistic, our focus on wellness is really unique to the older adult population. I think it really resonates with them. And I think that our presence in this market is going to be really well received.
new video loaded: What Trump Told Us About the ICE Shooting
By Zolan Kanno-Youngs, Alexandra Ostasiewicz, Nikolay Nikolov and Coleman Lowndes
January 8, 2026
Good morning. You’re reading the Up First newsletter. Subscribe here to get it delivered to your inbox, and listen to the Up First podcast for all the news you need to start your day.
Today’s top stories
An Immigration and Customs Enforcement officer shot and killed 37-year-old Renee Nicole Good, a Minneapolis woman, yesterday. Multiple observers captured the shooting on video, and community members demanded accountability. Minnesota law enforcement officials and the FBI are investigating the fatal shooting, which the Trump administration says was an act of self-defense. Meanwhile, the mayor has accused the officer of reckless use of power and demanded that ICE get out of Minneapolis.
People demonstrate during a vigil at the site where a woman was shot and killed by an immigration officer earlier in the day in Minneapolis, Minnesota, on Jan. 7, 2026. An immigration officer in Minneapolis shot dead a woman on Wednesday, triggering outrage from local leaders even as President Trump claimed the officer acted in self-defense. Minneapolis Mayor Jacob Frey deemed the government’s allegation that the woman was attacking federal agents “bullshit,” and called on Immigration and Customs Enforcement (ICE) officers conducting a second day of mass raids to leave Minneapolis.
Kerem Yucel/AFP via Getty Images
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- 🎧 Caitlin Callenson recorded the shooting and says officers gave Good multiple conflicting instructions while she was in her vehicle. Callenson says Good was already unresponsive when officers pulled her from the car. Homeland Security Secretary Kristi Noem claims the officer was struck by the vehicle and acted in self-defense. In the video NPR reviewed, the officer doesn’t seem to be hit and was seen walking after he fired the shots, NPR’s Meg Anderson tells Up First. Anderson says it has been mostly peaceful in Minneapolis, but there is a lot of anger and tension because protesters want ICE out of the city.
U.S. forces yesterday seized a Russian-flagged oil tanker in the north Atlantic between Iceland and Britain after a two-week chase. The tanker was originally headed to Venezuela, but it changed course to avoid the U.S. ships. This action comes as the Trump administration begins releasing new information about its plans for Venezuela’s oil industry.
- 🎧 It has been a dramatic week for U.S. operations in Venezuela, NPR’s Greg Myre says, prompting critics to ask if a real plan for the road ahead exists. Secretary of State Marco Rubio responded that the U.S. does have a strategy to stabilize Venezuela, and much of it seems to involve oil. Rubio said the U.S. would take control of up to 50 million barrels of oil from the country. Myre says the Trump administration appears to have a multipronged strategy that involves taking over the country’s oil, selling it on the world market and pressuring U.S. oil companies to enter Venezuela.
Health Secretary Robert F. Kennedy Jr. released new dietary guidelines for Americans yesterday that focus on promoting whole foods, proteins and healthy fats. The guidance, which he says aims to “revolutionize our food culture,” comes with a new food pyramid, which replaces the current MyPlate symbol.
- 🎧 “I’m very disappointed in the new pyramid,” Christopher Gardner, a nutrition expert who was on the Dietary Guidelines Advisory Committee, tells NPR’s Allison Aubrey. Gardner says the new food structure, which features red meat and saturated fats at the top, contradicts decades of evidence and research. Poor eating habits and the standard American diet are widely considered to cause chronic disease. Aubrey says the new guidelines alone won’t change people’s eating habits, but they will be highly influential. This guidance will shape the offerings in school meals and on military bases, and determine what’s allowed in federal nutrition programs.
Special series
Trump has tried to bury the truth of what happened on Jan. 6, 2021. NPR built a visual archive of the attack on the Capitol, showing exactly what happened through the lenses of the people who were there. “Chapter 4: The investigation” shows how federal investigators found the rioters and built the largest criminal case in U.S. history.
Political leaders, including Trump, called for rioters to face justice for their actions on Jan. 6. This request came because so few people were arrested during the attack. The extremists who led the riot remained free, and some threatened further violence. The government launched the largest federal investigation in American history, resulting in the arrest of over 1,500 individuals from all 50 states. The most serious cases were made by prosecutors against leaders of the Proud Boys and Oath Keepers. For their roles in planning the attack against the U.S., some extremists were found guilty of seditious conspiracy. Take a look at the Jan. 6 prosecutions by the numbers, including the highest sentence received.
To learn more, explore NPR’s database of federal criminal cases from Jan. 6. You can also see more of NPR’s reporting on the topic.
Deep dive
U.S. President Donald Trump speaks during a news conference in the Roosevelt Room of the White House in Washington, DC.
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U.S. President Donald Trump speaks during a news conference in the Roosevelt Room of the White House in Washington, DC.
Andrew Harnik/Getty Images
Trump takes 325 milligrams of daily aspirin, which is four times the recommended 81 milligrams of low-dose aspirin used for cardiovascular disease prevention. The president revealed this detail in an interview with The Wall Street Journal published last week. The U.S. Preventive Services Task Force recommends that anyone over 60 not start a daily dose of aspirin to prevent cardiovascular disease if they don’t already have an underlying problem. The group said it’s reasonable to stop preventive aspirin in people already taking it around age 75 years. Trump is 79. This is what you should know about aspirin and cardiac health:
- 💊 Doctors often prescribe the low dose of aspirin because there’s no benefit to taking a higher dose, according to a large study published in 2021.
- 💊 Some people, including adults who have undergone heart bypass surgery and those who have had a heart attack, should take the advised dose of the drug for their entire life.
- 💊 While safer than other blood thinners, the drug — even at low doses — raises the risk of bleeding in the stomach and brain. But these adverse events are unlikely to cause death.
3 things to know before you go
When an ant pupa has a deadly, incurable infection, it sends out a signal that tells worker ants to unpack it from its cocoon and disinfect it, a process that results in its death.
Christopher D. Pull/ISTA
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Christopher D. Pull/ISTA
- Young, terminally ill ants will send out an altruistic “kill me” signal to worker ants, according to a study in the journal Nature Communications. With this strategy, the sick ants sacrifice themselves for the good of their colony.
- In this week’s Far-Flung Postcards series, you can spot a real, lone California sequoia tree in the Parc des Buttes Chaumont in Paris. Napoleon III transformed the park from a former landfill into one of the French capital’s greenest escapes.
- The ACLU and several authors have sued Utah over its “sensitive materials” book law, which has now banned 22 books in K-12 schools. Among the books on the ban list are The Perks of Being a Wallflower and Wicked: The Life and Times of the Wicked Witch of the West. (via KUER)
This newsletter was edited by Suzanne Nuyen.
new video loaded: Minnesota Governor Condemns ICE Shooting
transcript
transcript
Minnesota Governor Condemns ICE Shooting
Governor Tim Walz of Minnesota slammed the fatal shooting of a woman by an immigration agent. President Trump said that the agents had acted in self-defense.
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This morning, we learned that an ICE officer shot and killed someone in Minneapolis. We have been warning for weeks that the Trump administration’s dangerous, sensationalized operations are a threat to our public safety, that someone was going to get hurt. Just yesterday, I said exactly that. What we’re seeing is the consequences of governance designed to generate fear, headlines and conflict. It’s governing by reality TV. And today, that recklessness cost someone their life.
By Jiawei Wang
January 8, 2026
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Video: Minnesota Governor Condemns ICE Shooting
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