Closing Georgia’s coverage gap could provide lifeline to young people with mental health issues – Georgia Budget and Policy Institute

About the author:

Rox Moffett is policy and news strategist for the Georgia Youth Justice Alliance.

Hillary Dong is a health policy fellow at the Georgia Budget and Policy Institute.

I have struggled with mental health since elementary school. I was bullied and ostracized, which had a detrimental impact on my mental health as an adult. After battling self-harm and suicide attempts in high school, I received Medicaid and received help from a mental health provider. Although my parents were against me being prescribed antidepressants, I knew I needed long-term mental health care, especially medication, to try to live a productive life. If I hadn’t been eligible for Medicaid throughout my childhood and teenage years, I would never have been able to afford the care and medications I received, and I’m not sure what I would do without it. Now that I am older and no longer eligible for Medicaid, life-saving care and my ability to purchase much-needed prescription drugs are at risk.

My story is not unique. The fight for mental health care is an uphill battle in Georgia. With suicides and drug overdoses soaring, it’s clear that accessible mental health and substance use disorder services are more important than ever. Full expansion of Medicaid is critical to meeting this need.

Currently, Georgia ranks 49thth Hundreds of thousands of residents fall into coverage gaps when it comes to accessing mental health care. These people earn too much to qualify for Medicaid, but not high enough to qualify for the subsidies that make marketplace health plans affordable. If Georgia were to fully expand Medicaid without burdensome work requirements or monthly reporting, more than one in four Georgians with behavioral health issues could get the care they need. Under full expansion in Georgia, young people ages 19 to 34 will account for more than half of the people getting health insurance.

The impact of the mental health crisis is profound, with Georgia’s young people and communities of color facing disproportionate barriers to accessing care.

As the nation’s largest single payer for behavioral health services, Medicaid plays a critical role in improving access and equity in mental health and substance use disorder (SUD) treatment. Since 2021, suicide rates have increased in the United States, especially among Black and Latino communities. While this upward trend was seen across the country, states that fully expanded Medicaid saw smaller increases than states that did not expand Medicaid.

Additionally, a Georgetown University report shows that Medicaid expansion increases access to opioid addiction treatment, which is critical in Georgia, where the epidemic has claimed countless lives. In 2022, drug overdose was the leading cause of premature death in Georgia.

Unfortunately, many Georgians, especially Georgians of color, still lack access to health care: approximately 15% of Black Georgians and 31% of Latino Georgians are uninsured. Nearly 60% of uninsured adults in Georgia’s coverage gap are people of color. Closing this coverage gap is an important step toward a more equitable health care system.

Early intervention and preventive care are key to addressing mental health challenges. About 50% of mental disorders begin by age 14, but many people don’t receive treatment until years later.By providing health insurance to people with coverage gaps, full Medicaid expansion could provide people with more timely access to treatment, Especially for young people.

Critics dispute the cost, but the data is clear: Full Medicaid expansion would cover more Georgians and cost each new enrollee five times less than the current Coverage Pathway program. Additionally, incentives provided by the American Rescue Plan will make the first two years of full expansion cost net zero. Not only does this investment make good financial sense, it’s also a compassionate and humane decision.

Medicaid expansion is more than a policy shift; it’s a lifeline for many young people who would otherwise struggle to pay for care or be forced to go without the support they desperately need. Medicaid expansion allows individuals to perform better in schools, workplaces, and communities. A 2018 survey showed that college counseling services improve academic performance and retention rates.

Full Medicaid expansion could be a beacon of hope for Georgia. It’s a path forward that intertwines resilience, opportunity and hope to create brighter futures for young people across the state. State leaders must prioritize the mental health and well-being of Georgians. Our future depends on it, and the time to act is now.


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