H.R. 3266: Mental Health Infrastructure Improvement Act of 2025

The Mental Health Infrastructure Improvement Act of 2025 aims to enhance mental health care facilities across the United States by enabling the Secretary of Health and Human Services to provide loans and loan guarantees. Below are the core components of the bill:

Loan and Loan Guarantee Program

The Act will amend the Public Health Service Act to establish a program for the following:

• Providing loans and loan guarantees to eligible entities for planning, constructing, or renovating facilities dedicated to pediatric or adult mental health treatment and substance use disorder services.
• Improving digital infrastructure and telehealth capabilities at these facilities.
• Adding or converting beds in these facilities to increase inpatient capacity for psychiatric and substance use disorders.

Preference and Allocation

When issuing loans or loan guarantees, the Secretary will prioritize applications that seek to:

• Increase the number of psychiatric and substance use disorder treatment beds in areas that currently lack sufficient capacity.
• Offer services in high-need rural or underserved communities.
• Provide comprehensive care across various mental health and substance use disorder services.
• Handle complex cases that require specialized care.

Additionally, at least 25% of the funds allocated each fiscal year will be designated for facilities primarily serving children and adolescents.

Loan Terms and Conditions

The Secretary will establish specific terms for the loans and loan guarantees, which will include:

• Loans will typically have a maximum term of 20 years or half the useful life of the financed asset.
• The government will guarantee no more than 80% of any potential loss from the loan.
• Borrowers must finance at least 25% of the project from non-federal sources.
• Interest rates for loans will be set considering government costs and comparable private sector rates.

Refinancing Limitations

The bill imposes specific conditions on refinancing loans. It allows refinancing only for loans made within 24 months before the enactment of this Act, and this authority will expire 24 months after the bill’s enactment.

Default Provisions

If a borrower defaults on a loan guaranteed by the Secretary, the Secretary will cover 75% of the loss, and will have the right to recover this amount from the borrower. The Attorney General will enforce any rights that the United States has as a result of the loan guarantee.

Trust Fund Establishment

The Act establishes the Mental Health and Substance Use Treatment Trust Fund within the U.S. Treasury. This fund will receive amounts equivalent to any revenues from the loan and guarantee program that surpass the costs involved in administering the program. Funds from the Trust will be allocated for community mental health services.

Funding Limitations

The program will be capped at a total of $200 million in loans and guarantees for fiscal years 2026 through 2030, and the Secretary will have to ensure appropriations are made in advance for these funds.

Definitions

Several terms are specifically defined in the bill to clarify eligibility and scope:

• Children’s hospitals, critical access hospitals, and various types of treatment facilities are detailed, as well as what constitutes mental health treatment and substance use disorder treatment facilities.
• The bill specifies that mental health treatment facilities include those providing a range of outpatient services and facilities for acute inpatient treatment.

Relevant Companies

• MCK - McKesson Corporation: Involved in health care management and pharmaceutical distribution, which may see impacts through increased demand for services.
• UNH - UnitedHealth Group: A major health insurer that could be affected as mental health services become more accessible, potentially increasing demand for coverage.
• CNC - Centene Corporation: A health care company focused on serving under-insured populations that might benefit from increased treatment facilities and services arising from the bill.