A common adage in crisis planning is that a community should not wait until there is a fire before they decide whether to build a fire department.

For many Chicagoans and others, the enactment of the “One Big Beautiful Bill Act” has lit a match and tossed it toward our resources for critical health care in 2026. This matters not only for the countless among us who directly depend on the Affordable Care Act and Medicaid for fundamental behavioral health services, but it will indirectly affect all of us in deeply critical ways. The time for collaborative planning, innovation and leadership is now instead of waiting for when — not if — the crisis arrives.

For thousands of Chicagoans, the ACA and Medicaid are the only ways to afford mental health treatment. Having insurance means you can access local services, which, in turn, promotes continuity of care and stability.

No more. This new legislation imposes significant cuts to Medicaid, which will result in scores of Chicagoans losing such benefits.

People will still get sick or live with untreated illnesses and the costs, and harm, borne by all of us, will only get worse.

At NAMI Chicago — the National Alliance on Mental Illness’ local affiliate— people call our helpline every day. In many instances, people don’t know where to go for help for themselves or a loved one who is experiencing symptoms of a mental health condition.

Looking ahead, these cuts will eviscerate the already unreliable and uneven access to services for serious mental illnesses across the city. The calls to our helpline will undoubtedly increase as many won’t know where to turn for care. Waitlists will grow.

Emergency room visits will spike.

The sick will get sicker.

And all around us, we’ll experience and witness more mental health crises and consequential encounters with law enforcement, jails and emergency rooms. In short, our already tattered mental health safety net will be shredded.

These community problems, inflamed by these looming cuts, require a community response.

Chicago can meet the moment.

Now is the time to prepare and collaborate.

Public-private partnerships across the city and county can innovate and rally around those among us who will need help.

No single provider or health center can solve for what’s ahead, but we are a city filled with compassionate advocates. We take care of one another when things get tough. That will be what’s actually beautiful about this bill and the response we give it.

Matt Davison, CEO, NAMI Chicago