As millions of Americans open notices about their 2026 health insurance premiums, the sticker shock is real. Average out-of-pocket premiums are expected to more than double — $888 annually in 2025 to $1,904 in 2026 — due to the expiration of enhanced Affordable Care Act subsidies. The political fight over these subsidies has dominated headlines and even triggered a government shutdown.
But as Washington debates the critical question of how much Americans should pay for health care, we must ask ourselves additionally, what are we getting in return?
It is a question I have often asked myself. Through my own battles with bipolar disorder and addiction, I saw that untreated mental illness doesn’t just affect the mind — it ravages the body. Yet our system continues to treat mental and physical health separately, leading to costlier, subpar care.
The U.S. currently spends about $478 billion annually in unnecessary expenses related to mental health inequities. If left unaddressed, this could increase to $1.3 trillion by 2040. These costs stem from treating chronic physical conditions exacerbated by untreated mental health issues, emergency department overutilization when patients lack behavioral health access, and lost workplace productivity.
Researchers are increasingly focused on the mind-body connection, exploring how mental health challenges can trigger serious illness. Yet we continue treating symptoms while ignoring root causes. Consumers, employers and insurers are all footing the bill for a system that costs more and delivers less.
The solution exists, and it works. Integrated care — treating mental and physical health together as comprehensive patient care — has demonstrated remarkable results in both health outcomes and cost savings.
Recent research on integrated care models for patients with diabetes and depression showed the approach to be cost-effective from health system, multi-payer, and societal perspectives. Studies show that patients receiving treatment in integrated models have better outcomes compared with those receiving regular care, and while these models may have higher direct costs initially, they reduce costs over time.
The fragmentation in our current system is particularly harmful. More than one in five American adults lives with a mental illness, yet only half receive treatment each year. This gap represents preventable emergency room visits, worsening chronic conditions, lost workdays, and premature deaths.
Consider the scale: Approximately 60 percent of Americans have at least one chronic disease, and 90 percent of the nation’s $4.5 trillion in annual health care expenditures are for people with chronic and mental health conditions. We cannot address America’s health care cost crisis without fundamentally changing how we approach mental and behavioral health.
Recent momentum offers hope. Health care leaders increasingly recognize the importance of integrating physical and mental health care, with many expecting greater emphasis on value-based care models in 2025. The Centers for Medicare and Medicaid Services has released collaborative care codes and proposed simpler billing processes. Thirty-three states and the District of Columbia now cover collaborative care in their Medicaid programs.
But we need to accelerate this shift. Even Congress’ Government Accountability Office recognized this in a recent report.
Employers and insurers must prioritize integrated care models. Primary care physicians should screen for and address mental health concerns. Behavioral health specialists should be embedded in primary care settings, and care coordination focused on outcomes that matter must be the norm, not the exception.
Policymakers must incentivize quality over volume. Rather than simply debate premium subsidies, we should ask whether insurers are covering evidence-based integrated care. Are they paying for better outcomes — not just whether people received treatment, but whether that treatment improved their health and functioning?
We need funding for implementation, especially for small providers serving vulnerable populations that often lack resources to transform their care delivery models.
Medical education must also change. The next generation of health care providers needs training that emphasizes the mind-body connection from day one, not as an afterthought.
We have to use today’s technology. Right now, our data systems cannot speak to each other well, affecting providers’ ability to communicate about mental and physical health. New technology can help bridge those gaps — but we must begin creating the guidelines and pursuing action now.
The Kennedy Forum, which I co-founded with my wife Amy, has set an ambitious goal: to ensure by 2033 that 90 percent of Americans with mental health conditions are accurately diagnosed, that 90 percent receive evidence-based care, and that 90 percent achieve recovery. This vision compels us to work together to deliver integrated care, data transparency and improved patient outcomes. It is about recognizing that quality care — care that addresses the whole person, mind and body together — is not just better medicine. It’s better economics.
Research has shown improved health outcomes and quality of life in multiple conditions related to or exacerbated by stress, including chronic pain, anxiety, depression, cancer-related fatigue, inflammatory bowel disease, and cardiovascular disease. Preliminary findings suggest that integrating these approaches may reduce health care utilization and be cost-effective.
This isn’t about partisan politics. It is about recognizing that quality care — care that addresses the whole person, mind and body together — is not just better medicine. It’s better economics.
As Congress works on averting double digit premium increases for working Americans, it must also guarantee that our dollars pay for outcomes that help people live better lives. The evidence is clear, the tools exist, and the real savings will come when we align our spending with what truly makes us well.
Patrick J. Kennedy is a former U.S. representative from Rhode Island and co-founder of The Kennedy Forum, a leading advocate for mental health integration and comprehensive care.
