Mike Franz, MD, executive medical director of behavioral health at Cambia Health Solutions, told Becker’s affordability is top of mind in terms of national policy.
There is data to back him up. The availability and affordability of healthcare rank among Americans’ top concerns in 2026 in a recent Gallup survey, with 61% reporting they are personally worried about the issue.
A range of policy changes could further strain coverage and costs. For example, HR 1 is estimated to reduce federal Medicaid spending by $911 billion over 10 years, and up to 10 million people could lose coverage when combined with the expiration of enhanced ACA subsidies. Medicaid currently insures about 15 million people with mental illness — roughly 29% of the 52 million nonelderly adults with such conditions.
Dr. Franz shared what concerns him most about the healthcare landscape at the moment.
Note: This response has been lightly edited for length and clarity.
Question: What’s top of mind in terms of policy right now?
Dr. Mike Franz: For a while there, I thought we had made so much progress on access. We’ve really moved the needle by adding providers in a virtual forward way, such that our members can get access to care almost always within seven days, and even with psychiatry, sometimes within 48 hours.
But the national picture has changed lately. I’m really concerned about the affordability of healthcare; that’s my biggest concern. And how will that impact access? Like will our members on our individual plans who no longer have the enhanced subsidies be able to still pay premiums that have increased, or [how will] the cost of the healthcare delivery system and the pressure that’s putting on premiums impact affordability? These are complex, challenging questions that don’t have a simple answer.
But increasingly from a policy level — and this is more of a national [perspective] — it’s about how do we make healthcare affordable? So that all people can access it in a way that doesn’t bankrupt them in other ways? Sometimes people have to pick whether they’re going to pay for their pharmaceuticals versus their food, and this gravely concerns me. My work here now every day is, how do we improve affordability?
At the Becker's Fall Behavioral Health Summit, taking place November 4–5 in Chicago, behavioral health leaders and executives will explore strategies for expanding access to care, integrating services, addressing workforce challenges and leveraging innovation to improve outcomes across the behavioral health continuum. Apply for complimentary registration now.
