As millions of Americans receive their health insurance premium notices for 2026, many are likely to feel a sense of sticker shock. The average out-of-pocket premiums are predicted to skyrocket—from about $888 in 2025 to $1,904 in 2026—due to the end of enhanced subsidies under the Affordable Care Act. This issue has fueled political debates and even led to a government shutdown.
While lawmakers tussle over how much citizens should spend on healthcare, a crucial question arises: what do we truly get in return for our investment?
It’s a question I often ponder. Personally, my journey through bipolar disorder and addiction has taught me that untreated mental illness impacts not just the mind but the body as well. Unfortunately, our healthcare system tends to compartmentalize mental and physical health, resulting in higher costs and lower-quality care.
Currently, the U.S. sees about $478 billion each year wasted on mental health inequities. If no changes are made, this figure could climb to a staggering $1.3 trillion by 2040. Many of these expenses are linked to chronic physical illnesses exacerbated by untreated mental health conditions. When patients can’t access behavioral health services, we see overuse of emergency departments and decreased workplace productivity.
Researchers are increasingly examining the link between mental and physical health. Yet, despite this focus, we seem to treat symptoms while overlooking the root causes. Whether it’s consumers, employers, or insurers, we’re all stuck in a costly, low-quality system.
Fortunately, there are effective solutions. Integrated care, which combines mental health and physical health treatment in a comprehensive approach, has shown substantial benefits in both health outcomes and cost savings.
Recent studies indicate that integrated care models—especially for patients living with diabetes and depression—are cost-effective for health systems, payers, and society as a whole. While these models may have initially higher direct costs, they often lead to savings over time and yield better health outcomes than traditional care.
The fragmentation in our current systems is particularly problematic. Nearly 1 in 5 American adults wrestles with mental illness, yet only about half receive treatment annually. This gap translates into emergency room visits that could have been avoided, worsened chronic conditions, lost work days, and even untimely deaths.
Let’s consider the scale: roughly 60 percent of Americans live with at least one chronic disease, and healthcare expenses account for a whopping 90 percent of the U.S.’s $4.5 trillion annual healthcare spending. Without fundamentally rearranging our approach to mental and behavioral health, we can’t hope to tackle the nation’s healthcare cost crisis.
There’s a glimmer of hope on the horizon. More and more healthcare leaders are recognizing the need for integrating physical and mental health, and there’s an expectation for increased focus on value-based care models moving into 2025. The Centers for Medicare and Medicaid Services are also promoting joint care codes and a simpler billing process. Currently, 33 states plus D.C. include collaborative care in their Medicaid programs.
But we need to speed up these changes. The Congressional Government Accountability Office recently acknowledged this necessity in a report.
It’s essential for employers and insurers to prioritize integrated care models. Primary care doctors should screen for mental health issues, and mental health professionals ought to be part of primary care teams, with care coordination aiming at meaningful outcomes becoming standard practice.
Moreover, policymakers should promote quality over quantity. Instead of merely discussing premium subsidies, we need to ask if insurance companies are covering integrated care that’s evidence-based. Are they focusing on better health outcomes—not just whether people receive some treatment, but if that treatment leads to improved health and functioning?
Resources are especially critical for smaller healthcare providers serving vulnerable populations, as these entities often lack the necessary resources to overhaul their care delivery methods.
We also need to revamp medical education. Future healthcare providers should be trained from the outset to understand the mind-body connection instead of considering it an afterthought.
And we must leverage today’s technology. Our current data systems don’t communicate effectively, hindering healthcare providers’ ability to share information about mental and physical health. New technologies could bridge these gaps, but we need to create guidelines and take action now.
At the Kennedy Forum, which I co-founded with my wife Amy, we’ve set ambitious goals. By 2033, we aim for 90 percent of Americans with mental health conditions to be accurately diagnosed, receive evidence-based care, and recover. Achieving this vision requires collaborative efforts to deliver integrated care, ensure data transparency, and enhance patient outcomes. Recognizing that quality care is about treating the whole person—mind and body—is essential for both better medicine and economic efficiency.
Numerous studies indicate that integrating care can improve health outcomes and quality of life across various stress-related conditions, like chronic pain, anxiety, depression, cancer-related fatigue, inflammatory bowel disease, and cardiovascular issues. Early findings suggest that this integrated approach can reduce healthcare utilization and be financially beneficial.
This isn’t a partisan issue; it’s simply about understanding the value of quality care. Congress must act to prevent double-digit premium hikes for working Americans, while also ensuring our health expenditures lead to better living conditions. The evidence exists; the tools are available. Real savings could emerge from aligning our spending with what genuinely enriches lives.
