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I have tried to engage in medicaid reform conversations with various folks at the state level. The insurance companies that states subcontract their Medicaid programs to prevent meaningful reform.

Most health systems have been closing behavioral medicine beds for years. The patients that fill beds in the facilities that still exist are usually on Medicaid or unfunded. It’s tough to breakeven on that type of payer mix. As noted, states have closed the state owned facilities, but the...