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Ending insurance reimbursement for supervised limited licensed therapists shrinks care access.

Policy may reduce training opportunities, threatening the mental health workforce pipeline.

Fewer supervised roles mean even longer wait times for patients needing mental health care.

As mental health professionals, we spend a great deal of time talking about access to care. We discuss long waitlists, provider shortages, geographic barriers, insurance limitations, and the growing demand for behavioral health services. Yet, sometimes barriers to care are created by policy decisions.

Blue Cross Blue Shield of Michigan's recent decision to discontinue reimbursement for services provided by limited licensed clinicians under supervision beginning in 2027 is one such policy.

While the stated rationale may be rooted in credentialing standards, the practical consequences deserve careful examination. This change is likely to affect patients, clinics, and the next generation of mental health professionals in ways that extend far beyond billing.

The Mental Health Workforce Doesn't Appear Overnight

Every fully licensed therapist was once a limited licensed therapist. The path to becoming an independently licensed clinician requires supervised clinical experience. New graduates enter the workforce with education and training, but they continue developing their skills under the guidance of experienced professionals. This apprenticeship model has long been a cornerstone of the mental health profession.

For decades, outpatient practices have served as critical training environments where........

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