2025 Council Hill Day

Investing in Psychology: Policy Grounded in Science

Sample Thank You Note to Send After Your Visits

Hill Day Resources

Request #1: Finalize FY25 appropriations and support $30 million in FY26 Graduate Psychology Education Program (factsheet)

Background

The Graduate Psychology Education (GPE) Program is the nation’s primary federal program dedicated to the interprofessional education and training of doctoral-level health service psychologists. Established in 2002, GPE has the “two-for-one” benefit of supporting the interprofessional training of psychology graduate students and interns, while also expanding access to mental and behavioral health services for underserved populations in rural and urban communities. 

This request advances the APA Council Resolution on Advancing Health Equity in Psychology.

Sample Talking Points for States with GPE Grants:

• Completing the FY2025 funding cycle is crucial to ensuring that our government can continue to provide essential services without interruption. Delays in the funding process can lead to uncertainty and inefficiencies that affect not only federal operations but also the lives of countless Americans who rely on these services. I urge you to make this a top priority to avoid the negative impacts of a potential government shutdown and to ensure that our communities continue to thrive.
• Increased investments to support our nation’s psychological health and emotional well-being are needed now more than ever, as current data shows that 122 million Americans live in what HRSA designates as Mental Health Shortage Area.
• Our state currently benefits from [number] GPE grant(s) at [institution(s)], which support integrated training for psychology doctoral students and expand access to mental and behavioral health services for underserved populations in [region of state]. These grants are vital for building a robust mental health workforce.
• As you may know, there is a shortage of qualified mental health providers in our state, particularly in [rural/urban] areas. GPE funding is critical to increasing our state’s capacity to reduce health disparities and improve health care outcomes for high-need, underserved populations (e.g. older adults, children, individuals with chronic illness, veterans, victims of abuse, ethnic minority populations, and victims of natural disasters).
• The GPE program is currently funded at $25 million. Increasing this funding to $30 million in FY26 would significantly strengthen our efforts to expand the psychology workforce and ensure that more Americans have access to the mental health care they need.

Sample Talking Points for States without GPE Grants

• Completing the FY2025 funding cycle is crucial to ensuring that our government can continue to provide essential services without interruption. Delays in the funding process can lead to uncertainty and inefficiencies that affect not only federal operations but also the lives of countless Americans who rely on these services. I urge you to make this a top priority to avoid the negative impacts of a potential government shutdown and to ensure that our communities continue to thrive.
• Increased investments to support our nation’s psychological health and emotional well-being are needed now more than ever, as current data shows that 122 million Americans live in what HRSA designates as Mental Health Shortage Area.
• As you may know, there is a shortage of qualified mental health providers in our state, particularly in [rural/urban] areas. Funding for GPE provides a critical mechanism that could help increase our state’s capacity to reduce health disparities and improve health care outcomes for high-need, underserved populations (e.g. older adults, children, individuals with chronic illness, veterans, victims of abuse, ethnic minority populations, and victims of natural disasters).
• Currently funded at $25 million, increased funding for GPE to $30 million in FY26 would strengthen current efforts to expand the psychology workforce by increasing opportunities for institutions in our state to apply for GPE funding.

Potential Pushbacks and Responses

DISCLAIMER: These questions are posed in the voice of a congressional staffer, to capture the type of language and pushback advocates may receive in their Hill meetings. The language does not represent the position or terminology of APA/APA Services. 

Our country is $36 trillion in debt and running a $2 trillion deficit this year alone.  We must make hard choices to reduce spending.  Why shouldn’t we cut spending for everything?

Graduate Psychology Education is a tiny investment – it comprises 0.00001% (one one-hundred-thousandth of one percent) of our annual deficit, so cutting the funding will do nothing to reduce overall spending.  But GPE pays huge dividends in increasing access to mental and behavioral health services for all Americans.  GPE has a two-for-one benefit, in that it benefits the training programs and health service psychologists training to provide care, and it also increases access to care for individuals in underserved areas, including rural communities. This small investment in the short-term can also yield lower healthcare costs in the long term, because the sooner people’s needs are identified, the sooner they can be treated before they escalate to a crisis point and rely on more costly care from emergency rooms, etc. But we need an adequate workforce to accomplish that. 

How do I know that GPE grants are not funding DEI?

What matters to GPE grantees and all health service psychologists is that all Americans have access to mental and behavioral health services, regardless of race, religion, or geography.  Data shows that the shortage of mental and behavioral health care is most severe in rural areas, where families and individuals are more than twice as likely to lack any to these critical services whatsoever.  That is why current GPE grantees include programs in Missouri, Nebraska, Texas, South Dakota, South Carolina, Kentucky, Kansas, and other states with high rural populations.  Data also shows that health service psychologists are highly likely to stay in the area where they train, so funding GPE grantees that serve rural areas ends up increasing access to care for residents of those regions in the future.  

Why shouldn’t the federal government leave this to the private sector?

Our nation invests in developing the health workforce not because we hope to turn a profit, but because it is key to Americans’ health.  We can and should invest in developing the workforce of mental and behavioral health professionals, just like we invest in training nurses, primary care physicians, dentists, substance abuse counselors, and many other allied health professionals.  If the federal government stops investing in developing the workforce of health professionals, the effect will be to decrease access to all forms of health care for all Americans.   

Frequently Asked Questions

Q: A Congressional Office has asked us to fill out an FY26 Appropriations Request Form for GPE. What should I do?

A: All the information to fill out an FY26 Appropriations Request Form for GPE can be found here. If you have any questions, please reach out to Raegina Likewise at rlikewise@apa.org 

Q: What has GPE been funded at historically? 

A: Historical funding for GPE can be found at the bottom of this page.

Additional resources

• Check whether you live or work in a Mental Health Health Professional Shortage Area here.
• More information on health workforce shortages from APA’s Center for Workforce Studies can be found here.

Request #2: Finalize FY25 NIH appropriations at no less than the Senate level of $50.3 billion and support robust, sustained funding for NIH in FY26 (factsheet)

Background

The National Institutes of Health (NIH) is the premier funder of biomedical and behavioral research with the mission to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability. Improving the health of all Americans is a core component of NIH’s research mission, which includes a focus on disease prevention and health promotion. This includes support of mental health, behavioral, and social science research, which is especially valuable to health promotion and disease prevention.

This request advances the APA Council Resolution on Psychology’s Role in Advancing Population Health

Sample Talking Points

• People everywhere benefit from medical research supported by the NIH, which serves as the foundation for nearly every preventive intervention, diagnostic, treatment, and cure in practice today
• Nearly every medication, diagnostic, and other intervention in practice today has its origins in NIH-funded research. 
• NIH investment takes place in every state and in nearly every congressional district.
• More than 95% of the investment in NIH goes directly to research awards, programs, and centers; training programs; and research and development contracts.
• NIH supports the economy via its funding of more than 60,000 grants to 300,000 researchers at more than 2,500 institutions across the country. 
• Many of today’s key population health issues, including addiction, violence, climate change, and trauma—involve important psychological components. 
• Individual and population-level behaviors, studied by psychologists, often represent risk factors for a variety of health issues, including chronic diseases such as heart disease, cancer, diabetes, and mental health problems.
• NIH-supported behavioral and social science research has revealed behavior’s vast role in health.
• Behavioral and social sciences research has a valuable role in health promotion and disease prevention because the research suggests that the chronic disease burden and all-cause mortality rates in the U.S. may be largely attributed to preventable high-risk behaviors, such as low physical activity, high sedentary behavior, poor diet, and tobacco and alcohol use.

Potential Pushbacks and Responses

DISCLAIMER: These questions are posed in the voice of a congressional staffer, to capture the type of language and pushback advocates may receive in their Hill meetings. The language does not represent the position or terminology of APA/APA Services. 

NIH needs reforming. Both the House and the Senate have identified areas where reform is needed:

APA agrees that Congress has an oversight role. NIH reform should be done in an open and transparent manner with input from the agency’s stakeholders and other experts. The desire for a “deliberative and engaging process” is a worthy goal. Accordingly, the association looks forward to a robust discussion by Congress, NIH, stakeholders, and organizational experts of what is needed to optimize the NIH’s organizational structure to fulfill its mission. A review is the first step. There are a number of questions that it is important to know the answer to: Are we doing the right science? Where is there duplication of efforts and gaps in the research? What processes are needed to improve coordination and integration of programs across the NIH? 

Why should the federal government fund this research rather than the private sector?

NIH research is widely considered a “public good” because the knowledge and advancements generated through its funding studies benefit the entire population.  

Private investments in labs or donations to university research programs can be very erratic, based on shifting goals, priorities, trends and the personal fortunes of funders. Good research needs consistent and stable funding to provide needed insights, and that’s why there is a role for the federal government in funding psychological research.   

Frequently Asked Questions

Q: How does the NIH decides what research it will fund? 

A: The NIH grant process is highly competitive. The agency has three application, review, and award cycles per year. Applicants compete for the same funds unless a funding opportunity specifically indicates money has been set aside for awards. The agency receives many applications. The overall chance that an application will be funded is around 20% also known as the success rate.  Nevertheless, the agency awards more than 11,000 awards each year. 

Q: What is the peer review process?

A: The NIH peer review process is the cornerstone of the NIH extramural research program which seeks to ensure that applications for funding “receive fair, independent, expert, and timely scientific reviews – free from inappropriate influences – so that NIH can fund the most promising research.” The NIH has a dual-level peer review process which relies on individuals with expertise in various scientific and technical fields who volunteer their time to help the agency rigorously evaluate grant applications for the scientific and technical merit. The second-level review for mission relevance is conducted by members of national advisory councils for NIH institutes and centers (ICs) and the NIH Office of the Director. IC directors make the final funding decisions taking into consideration their IC’s research program priorities in the context of the existing funding portfolio.

Q: 

Additional Resources

• See the impact of NIH funding in your state here.
• Learn more about estimated losses of NIH funding by state here.
• Learn more about the estimated losses of NIH funding for institutions in your state here.
• NIH Awards by Location & Organization - Explore year-by-year NIH funding by institution, state, congressional district, and more using this link. 
• Learn more about the National Institutes of Health
• Learn more about NIH Research Grants and Funding here.
• Learn more about NIH Grants Policy (Animals in Research, Human Subjects Research, Research Integrity, etc.) here. 

Request #3: Protect Access to Behavioral Health Services in Medicaid (factsheet)

Background

• While states have ample discretion to design their Medicaid programs, certain services are considered “mandatory benefits” that must be covered in every Medicaid program. These include, but are not limited to, inpatient and outpatient hospital services, rural health clinic (RHC) and federally qualified health center (FQHC) services, nursing facility services, physician services, and early and periodic screening, diagnosis, and treatment (EPSDT) services for children under age 21.
• Psychologists’ services do not fall under any “mandatory benefit” category and are considered optional services under 42 CFR 440.60. Medicaid coverage and reimbursement for behavioral health services varies greatly across states.  Typically, Medicaid programs’ reimbursement rates are significantly less than Medicare.
• Congress can incentivize states to engage in certain behaviors through an increased federal matching percentage rate (known as FMAP); for example, under the Affordable Care Act (ACA), states are offered an increased FMAP in exchange for expanding eligibility for Medicaid programs to nearly all non-elderly adults with incomes up to 138% of the Federal Poverty Level. 
• States can also request waivers from the federal government to operate specialized programs to meet particular needs or populations within the state, or to operate a managed care program to contain their Medicaid costs. A large and growing majority of states utilize a managed care system to administer at least a portion of the services covered under their Medicaid program.
• States are not required to establish a Medicaid program, although every state, the District of Columbia, and the U.S. territories currently have a Medicaid program. 
• This request advances the new APA Council Resolution on Advancing Evidence-Based Health Promotion and Prevention Across the Lifespan

Sample Talking Points

• Medicaid is the single largest source of coverage for behavioral health services. Without access to those services, many low-income children, adults, and families—including, but not limited to, those with disabilities—would lose access to life-saving mental, behavioral, and substance use disorder treatment.
• The loss of coverage for early intervention and preventative behavioral health services would also result in overall higher costs to the state, with many people experiencing a mental health crisis obtaining care in inappropriate settings like emergency rooms or jails/prisons.

Potential Pushbacks and Responses: 

DISCLAIMER: These questions are posed in the voice of a congressional staffer, to capture the type of language and pushback advocates may receive in their Hill meetings. The language does not represent the position or terminology of APA/APA Services. 

Wouldn’t additional eligibility requirements like work requirements encourage people currently using welfare programs to enter the workforce?

No. The majority of Medicaid enrollees are already working at least part-time hours. In states that have implemented these requirements in the past, many lose eligibility for Medicaid not because of actual non-compliance with the work requirement, but because of confusion or technical difficulties on reporting the hours that they have been working. 

New eligibility requirements like work requirements do not tend to save states or the federal government more money, but rather they direct more money towards administration of the program itself and away from reimbursement for actual services covered through the program.

Wouldn’t block-granting the federal share of Medicaid funds give states more flexibility and authority as to how they operate their own Medicaid program?

The Medicaid program is already built with a number of flexibilities for states, subject to some basic federal minimum standards. States have broad discretion to select the services they wish to cover, as well as determine the populations they want served by the program. Additionally, many states have contracted with a managed care organization to, among other goals, help contain the costs of their Medicaid program.

In practical terms, block-granting the Medicaid program would result in massive cuts to federal health care funds to states. Because the vast majority of states are unable to cover the remaining costs on their own, states would be left in the position of narrowing eligibility for the program and implementing deep cuts to services, including cuts to the already-low reimbursement rates received by providers serving Medicaid enrollees. 

Because each state has ample discretion to tailor its Medicaid program to its population needs, Medicaid has long been considered a laboratory for innovation through initiatives such as pilot programs and optional waivers. Cuts to federal health care funds to states would hamper states’ ability to explore new ways to meet population needs according to their unique geography and state culture while making efficient use of public dollars. The current Medicaid structure is already financially lean and facilitates innovation that could lead to better outcomes at lower costs. 

Isn’t there a lot of fraud in the Medicaid program (i.e. enrollment by undocumented immigrants)?

There are ample incentives and programs to detect, deter, and remedy any fraud, waste, and abuse in the program, but there is no evidence that immigrant communities or other ineligible people are unlawfully claiming benefits in the Medicaid system. Most undocumented immigrants are ineligible for Medicaid coverage; while certain “qualified non-citizens”—including asylees, refugees, lawful permanent residents, and victims of human trafficking—are potentially eligible for Medicaid, the evidence demonstrates that most immigrants do not claim federal benefits for which they are eligible, out of fear of these benefits affecting their immigration status.

Additionally, a steep cut to the federal Medicaid contribution to eliminate any illegitimate enrollment would also eliminate legitimate access to physical, mental, and behavioral health treatment for millions of low-income families and individuals with disabilities.

Frequently Asked Questions

Q: What is Medicaid and how is it funded?

A: Medicaid is a health insurance program jointly funded by state funds and a varying federal matching rate (FMAP). The Children’s Health Insurance Program (CHIP) is a related program that provides low-cost health insurance to children in families that earn too much income to qualify for Medicaid.

Q: Who and what does Medicaid cover?

A: That largely depends on the state operating the program. States have broad discretion to set eligibility criteria, select services covered by the program, and set provider reimbursement rates for their Medicaid program, subject to certain minimum criteria outlined in federal law.

Q: Do psychologists participate in the program? Why are we advocating for this program?

A: It is true that reimbursement rates for services commonly furnished by psychologists are often lower in Medicaid than for Medicare. As a result, clinical psychologists’ participation in Medicaid is low. However, Congress and the new Administration are looking to implement deep spending cuts to the Medicaid program, which is a lifeline to accessing mental and behavioral health services for many rural and underserved communities.Additionally, many Medicaid-eligible children and adolescents rely on accessing care through school-based mental health programs implemented and supported by their state Medicaid programs. 

Q: How will Congress cut funding for Medicaid?

A: At the moment, it is unclear whether and exactly how Congress intends to cut funding for the program, but we know that Medicaid cuts are on the table to help cover the cost of a major spending bill this spring.

Exactly how Congress could cut Medicaid funding is unclear, but several options have been floated, including:

• Block-granting/Per capita caps: Congress could decide to either convert all federal Medicaid funding into a single grant to the states or impose a fixed amount of federal spending per enrollee.
• Work requirements: Congress could alter the Medicaid eligibility criteria to require enrollees to participate in a certain number of “community engagement hours” per week (i.e. work, volunteer, etc.).
• Reduce federal matching funds: Congress could reduce the federal government’s contribution to state Medicaid programs and/or reduce or eliminate the enhanced matching rate for states that adopted the ACA’s Medicaid eligibility expansion.

Additional Resources

• Find key information about the Medicaid program in each state here.
• State-specific factsheets on Medicaid/CHIP enrollment of children and adolescents can be found here.
• Fact sheets on health insurance enrollment in each state can be found here.
• An APA interactive resource on prevalence of mental health indicators and psychologist availability in each state can be found here.
• View state snapshots of Medicaid and CHIP here.
• Learn more about Medicaid work requirements here. 

Q+A from Feb. 11 Issue Briefing

Q: Can we bring data that would support our argument? Even if it’s just drip feeding.  

A: Yes, absolutely! And if you do not get a chance to share it during the meeting, you can include it in your thank you note. If you are part of a group, please coordinate with the designated note sender to include the information. 

Q: I’ve talked to my representatives and had staffers give untrue statements. How do you suggest we handle misinformation that is given to us? 

A: We would recommend saying that their statement is not aligning with your experience (in the district, hearing from patients, from established research etc.), then pivoting to either another topic or the next talking point. We do not recommend engaging in a back and forth on a single point. You can find an example of navigating such a situation in this 4-minute video skit. 

Q: There was such a groundswell of bipartisan support to address the mental health crisis (especially youth) following COVID.  It was "popular" to support it.  Surely that will still matter for GPE and NIH and Medicaid?  

A: Yes, there is still strong support for addressing mental health needs in the nation. We recommend tying back to local needs in the district or state when pointing out the benefits of our asks during your meetings. 

Q: On the fact sheet for the NIH ask, it mentions various ways in which BSSR shapes health policies and improves health outcomes overall -- including vaccination campaigns and reducing health disparities. Given that vaccines and DEI are coming under fire in the current political climate, should we avoid bringing up these kinds of things? 

Depending on the office that you're speaking with, we would not recommend prioritizing those aspects of the agency. We don't want to get into a back-and-forth with individual staff defending the programs work. BSSR does work well beyond those programs and provides vital information back to the NIH, Congress, and taxpayers. It is okay to share how the research advances in these areas have led to good public health practices and have saved lives especially as it is related to the work that you do and its impact as related to the congressional district/local needs. But, again, it is important to not engage in a debate about these issues.  

Q: Can you clarify whether indirect costs to NIH are included in appropriations language?  In other words, theoretically, not subject to change?

A: It is not subject to change in FY 25 per the following language included in Public Law 118-47, March 23, 2024. It reads: 

SEC. 224. In making Federal financial assistance, the provisions relating to indirect costs in part 75 of title 45, Code of Federal Regulations, including with respect to the approval of deviations from negotiated rates, shall continue to apply to the National Institutes of Health to the same extent and in the same manner as such provisions were applied in the third quarter of fiscal year 2017. None of the funds appropriated in this or prior Acts otherwise made available to the Department of Health and Human Services or to any department or agency may be used to develop or implement a modified approach to such provisions, or to intentionally or substantially expand the fiscal effect of the approval of such deviations from negotiated rates beyond the proportional effect of such approvals in such quarter. 

The AAMC and 22 states lawsuit that halted the implementation of the NIH policy change noted that: 

In 2017, during his first administration, President Trump made a budget proposal that would have reduced the indirect cost rate for research institutions to an across-the-board, categorical rate of 10%.  Congress unequivocally responded to ward off such a change to the calculation of indirect cost rates.  In 2018, Congress enacted an appropriations rider prohibiting HHS or NIH from spending appropriated funds “to develop or implement a modified approach to” the reimbursement of “indirect costs” and “deviations from negotiated rates.”  Consolidated Appropriations Act, 2018, Pub. L. No. 115-141, 132 Stat 348, § 226.  That rider has remained in effect through every appropriations law governing HHS to this day.  See Further Consolidated Appropriations Act, 2024, Pub. L. No. 118-47, § 224     

Unfortunately, similar language will need to be negotiated again in FY26.    

Frequently Asked Questions

How can I prepare for the Hill Day?

All information for the Hill Day, including our legislative requests, fact sheets, agenda, and participant list can be found on this action center. If you are not seeing the information you are looking for, please check back later - this page will be updated as we receive more information. 

If you are new to advocacy or would like a refresher, please watch APA’s Federal Advocacy for Psychology video.

Do I have to schedule my Hill visits for February 20?

No. Our partner, Soapbox Consulting, is handling all scheduling for legislative hill visits for February 20.

When will I get by schedule from Soapbox?

All Hill meeting schedules will be emailed to you by Soapbox prior to the Hill Day on February 14. On the “Meeting Roster” button next to each meeting, you can find the names and email addresses of your fellow advocates for each meeting so you can reach out in advance to introduce yourselves.

What if I can no longer make the February 20 Hill visits?

Please contact us at advocacy@apa.org as soon as possible so we may remove you from the congressional meeting schedule.