Since North Carolina expanded Medicaid 18 months ago, approximately 650,000 residents have enrolled in the program. However, these individuals face potential loss of coverage due to provisions in President Donald Trump's One Big Beautiful Bill Act. Concurrently, mental health coverage is being rolled back under the Trump administration, which could result in more Americans foregoing necessary care. The 2025 budget reconciliation act has been described as the largest rollback of health insurance coverage in U.S. history, making it harder for individuals to qualify for and maintain Medicaid or subsidized Affordable Care Act coverage. Demand for remote mental healthcare remains high, exemplified by over 2 million calls to TeleMANAS, but budget cuts and staffing instability threaten the program's progress. The national 988 Suicide & Crisis Lifeline recently ended its dedicated support for LGBTQ+ youth, prompting states like California to partner with organizations such as The Trevor Project to train counselors and fill this gap. Crisis counselors emphasize the importance of maintaining the 988 lifeline to support mental health needs.