This brief describes the changes that state and federal governments are making and their potential implications for people with mental health conditions and substance use disorder (SUD). It focuses on changes being made in specific states through Medicaid demonstration waiver authority that focus on providing services at reentry. It also discusses national changes made through recent federal legislation that take effect in 2025. Finally, this brief describes legislative proposals that Congress is considering to further expand Medicaid’s role as people leave carceral facilities. It concludes by identifying next steps for these policies.