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Trump vows mental health care fix after Florida shooting. He also wants to slash coverage.

by Jane C. Timm /
U.S. President Donald J. Trump delivers remarks on the 14 February shooting at Marjory Stoneman Douglas High School in Parkland, Florida; in the Diplomatic Reception Room of the White House in Washington on Feb. 15, 2018.Michael Reynolds / EPA

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In the wake of a deadly school shooting in Florida, President Donald Trump called the confessed gunman "mentally disturbed" in a tweet and vowed his administration would "tackle the difficult issue of mental health."

Here’s what Trump's administration has done or proposed so far that would affect mental heath care in America.

This month, the president signed a two-year funding bill hammered out by congressional leaders that included $6 billion for opioid and mental health care. Days later, the White House's budget proposal — a suggestion to Congress, which will ultimately decide how to divvy up the government's money — said the president wanted to allocate $13 billion in mental health and opioid funding.

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Mental health care experts say those big dollar amounts obscure a dangerous reality: that same budget proposed massive cuts to Medicaid that they say would devastate the nation's mental health care system.

“Medicaid pays for about a quarter of mental health and substance abuse treatment in this country,” said Rebecca Farley David, vice president for policy and advocacy at the National Council for Behavioral Health.

Slashing Medicaid means taking mental health care from vulnerable populations, David said, even if grants elsewhere are tacked on.

“By and large, if we make major cuts to Medicaid, we lose any progress that we might make elsewhere,” she told NBC News.

Trump, in his brief remarks at the White House Thursday morning, spoke about securing the nation's schools — and underscored the need for meaningful action.

"We are committed to working with state and local leaders to help secure our schools, and tackle the difficult issue of mental health," he said. "Later this month, I will be meeting with the nation’s governors and attorney generals, where making our schools and our children safer will be our top priority. It is not enough to simply take actions that make us feel like we are making a difference. We must actually make that difference."

Andrew Sperling, the director of legislative and policy advocacy at National Alliance of Mental Illness (NAMI), noted that the White House has also allowed states to add work requirements to Medicaid coverage, something that undermines those seeking care for addiction or mental health requirements that could temporarily land them out of work, but not rise to the level of a permanent disability, which are excluded from work requirements.

“They’d lose access to the very treatment they need to get better,” Sperling said.

The president also quietly rolled back a contentious Obama-era regulation early last year that made it harder for people with mental illnesses to buy guns. Gun control and mental health advocates nationwide were split on this, with many in the latter group arguing that mental illness does not correlate with violence, while gun control supporters argued it was necessary.

Paul Gionfriddo, president and CEO of Mental Health America, said the country needs to rethink its approach to mental health entirely. Suicide rates keep rising as the mortality rates of other major killers like cancer dips because the nation invested in early, preventative care to catch symptoms early, he said.

"We never did that with mental illness. Here, we wait, and we wait, and we wait until we have crises," Gionfriddo said. "The lesson of yesterday is not what we’re going to do about the shooter, it’s what we’re going to do about all the victims of the shooting: Three thousand people in that school — they’ve all experienced a profound trauma, and yet we have no level one trauma centers for mental health in this country. We have no plan."

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