Closing Georgia’s Coverage Gap Could Provide a Lifeline for Young Adults with Mental Health Struggles

About the authors:

Rox Moffett is a Policy and Press Strategist with the Georgia Youth Justice Coalition. 

Hillary Dong is a Health Policy Fellow with the Georgia Budget and Policy Institute. 


I have struggled with mental health since elementary school. I was bullied and ostracized, which has had a detrimental impact on my mental health even now as an adult. After battling self-harm and a suicide attempt in high school, I was able to get Medicaid coverage and gain access to a mental health provider. Even though my parents opposed my prescribed antidepressants, I knew I needed long-term mental health care—especially medication—to attempt a productive life. If it weren’t for Medicaid that I was eligible for through childhood and adolescence, I would never have been able to afford the care and medicine that I received, and I am not sure where I would be without it. Now that I’m older and no longer qualify for Medicaid, that life-saving access to care and my ability to fill much-needed prescriptions is at risk.  

My story is not unique. In Georgia, the battle for accessible mental health care is an uphill struggle. With surges in suicide and drug overdoses, it’s clear that accessible mental health and substance use disorder services are more critical than ever. Full Medicaid expansion is vital to meeting that need.  

Currently, Georgia ranks 49th in access to mental health care and hundreds of thousands of residents fall into the coverage gap. These individuals earn too much to qualify for Medicaid but not 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—the more than 1 in 4 Georgians in the coverage gap with behavioral health conditions could gain access to the care they need. Young adults aged 19 to 34 would make up over half of those gaining health insurance under full expansion in Georgia.  

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

As the single largest payer for behavioral health services nationwide, Medicaid plays a pivotal role in increasing accessibility and equity in mental health and substance use disorder (SUD) treatment. Since 2021, the United States has seen increases in the suicide rate, especially among Black and Latinx populations. While this uptick has been observed nationwide, states that fully expanded Medicaid saw smaller increases than non-expansion states.  

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

Unfortunately, health care remains inaccessible for many Georgians, especially Georgians of color: about 15% of Black Georgians and 31% of Latinx Georgians are uninsured. Nearly 60% of uninsured adults in the coverage gap in Georgia are people of color. Closing this coverage gap is an essential step towards a more equitable healthcare system. 

Early intervention and preventative care are key to addressing mental health challenges. Approximately 50% of mental disorders begin by age 14, but many individuals do not access treatment until years later. By providing health insurance to those in the coverage gap, full Medicaid expansion could enable timelier access to treatment, particularly for young adults.

Critics argue about the cost, but the data is clear: full Medicaid expansion would cover more Georgians and cost the state five times less per new enrollee compared to the current Pathways to Coverage program. Moreover, incentives offered by the American Rescue Plan would render the cost of full expansion net zero for the first two years. Not only does this investment make good financial sense, but it’s also a compassionate and humane decision.  

Expanding Medicaid isn’t merely a policy shift; it’s a lifeline for many young adults who would otherwise struggle to cover the cost of care or be forced to go without the support they desperately need. Medicaid expansion can empower individuals to show up better in their schools, workplaces and communities. A 2018 survey revealed that counseling services in colleges improved academic performance and retention rates. 

Full Medicaid expansion could be a beacon of hope for Georgia. It is the way forward, allowing resilience, access and hope to intersect and create a brighter future for young adults 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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