“The Great American Recovery Initiative”: What President Trump’s New Executive Order Means for Behavioral Health Providers

On January 29, 2026, President Trump signed Executive Order 14379, titled: “Addressing Addiction Through the Great American Recovery Initiative” (Executive Order). The Executive Order establishes the White House Great American Recovery Initiative (Initiative). Although this initiative will not change day-to-day clinical practices to treat substance use disorders (SUDs), the Executive Order identifies the current administration’s policy priorities and will likely influence future funding decisions, regulatory changes, and enforcement efforts. Treatment providers and investors in the SUD treatment space may look to the Executive Order as a policy roadmap for the coming legislative cycles, at least during President Trump’s second term. 

Background

The Trump administration’s focus on access to treatment for SUDs is not new. During President Trump’s first term, the Centers for Medicare & Medicaid Services (CMS) approved 29 state Medicaid waivers aimed at improving treatment access for opioid use disorder (OUD) and other SUDs. These Section 1115 waivers allow states to tailor treatment options to what their local community needs. Under the waivers, states were permitted to test new flexibilities in how Medicaid beneficiaries receive SUD services, including the type, setting, and scope of covered care. The waivers were approved for either five- or ten-year periods.

Five Key Takeaways 

The Executive Order does not mandate any particular policy changes but sets forth five key themes that are aspirational in nature for SUD treatment policy: 

1. Expansion of Evidence-Based SUD Treatment

The Executive Order calls for SUD treatment to mirror the care framework used for other chronic diseases. It emphasizes evidence-based care, paired with community outreach, as the foundation for the “Great American Recovery”. Health care providers should anticipate additional grant opportunities that reward adoption of evidence-based SUD treatment modalities and care models. 

2. Emphasis on Access

The Executive Order underscores that many Americans with SUD remain unable to initiate and maintain needed treatment due to access barriers. This initiative may spur expanded telehealth flexibilities and innovative delivery models, where clinically appropriate, to increase access to care (for more information, read our blog titled “CMS ACCESS Model: Providers Prepare for Technology-Driven, Value-Based Care”). Federal agencies will be encouraged to identify ways to reduce barriers in rural and underserved areas. Under the current Drug Enforcement Administration (DEA) telemedicine prescribing flexibilities, which have been in place since 2020, patients may receive prescriptions for controlled medications via telehealth without a prior in-person visit through the end of 2026. However, DEA has not yet issued permanent rules to replace these temporary flexibilities.

3. Integration and Care Coordination

The Executive Order calls for improved coordination between federal agencies in addressing OUD and SUDs, particularly on how to implement programs that integrate prevention, early intervention, treatment, and recovery support. Health care providers may see continued movement toward value-based arrangements in the SUD and behavioral health space. For more information on value-based arrangements, please visit our Risk Bearing Entities blog series.

4. Increased Awareness

The Executive Order calls for an increased awareness of “the disease of addiction,” signaling that SUD will remain a prominent focus for the Trump Administration during the second term. Health care providers should expect to see continued public education campaigns, as well as expanded grant and waiver opportunities focused on SUD treatment, prevention, and recovery support services.  

5. Federal and State Program Cooperation

The Executive Order encourages federal agencies to consult with states and local jurisdictions as they develop new programs and policies. This emphasis on collaboration may result in a more united national strategy for addressing SUD, with closer alignment between federal initiatives and state Medicaid programs, public health agencies, and local behavioral health systems. Several days after the Executive Order was issued, the Department of Health & Human Services Secretary Robert F. Kennedy, Jr. announced a $100 million investment to fund targeted outreach, psychiatric care, medical stabilization, and crisis intervention services to fight opioid addiction and improve public safety.

Conclusion

The Executive Order is primarily a policy-setting tool, but it has concrete implications for how federal agencies will regulate and fund SUD treatment and behavioral health during President Trump’s second term and signals how the President’s supporters in Congress may look to legislate on these topics. 

To remain at the forefront of SUD treatment policy and be best positioned to leverage emerging regulatory and funding opportunities stemming from the Executive Order, health care providers and behavioral health centers should:

• Emphasize evidence-based SUD treatment;
• Leverage telehealth and innovative care delivery models where appropriate; and
• Position themselves for emerging federal and state funding opportunities, including grants and Medicaid waivers. 

As counsel experienced in health care regulatory compliance, transactions, and administrative law, Foley & Lardner is actively advising providers, hospital systems, and medical groups on the ever-changing landscape. Please reach out to the authors, your Foley relationship partner, or to our Health Care Practice Group and Health Care & Life Sciences Sector with any questions.