the national Association of Black Counselors

May 2025

The National Association of Black Counselors (NABC) vehemently opposes The One Big Beautiful Bill Act (H.R. 1) and its devastating cuts to Medicaid and Affordable Care Act (ACA) subsidies. These changes threaten mental health access for millions of Black Americans and violate our ethical mandate to advocate for equitable care.

The National Association of Black Counselors (NABC) condemns H.R. 1's Medicaid work requirements and ACA subsidy cuts, which threaten mental health access for Black communities. Verified data confirms:

Documented Impacts

1. 8 Million Medicaid Losses

   • Congressional Budget Office projects 8 million will lose coverage due to:

     • Administrative burdens of 80-hour monthly work requirements (CBO, 2024)

     • Coverage gaps mirroring Arkansas’ 18,000+ losses under similar policies (KFF, 2024)

2. 6 Million ACA Enrollees Priced Out

   • Terminating enhanced subsidies will spike premiums by 82% for low-income households (KFF, 2024)

   • Black Americans (34% of ACA enrollees) disproportionately affected (CMS, 2024)

Ethical Violations

These policies conflict with:

• ACA Code of Ethics (Section A.7): Prohibits policies that exacerbate care disparities

• NBCC Multicultural Guidelines: Require advocacy against systemic barriers

NABC’s Position

1. Reject H.R. 1 and all Medicaid work requirements

2. Permanently extend ACA subsidies to prevent coverage losses

3. Invest in culturally responsive safety nets

Next Steps

For advocacy instructions, refer to the May 30, 2025 email sent to all NABC members.

Endorsed by:

NABC Executive Committee
NABC Advocacy and Legislative Committee