Georgia Must Invest in Telehealth
In a state where nearly a third of rural residents lack the bandwidth to join a Zoom call, Georgia’s promise that telehealth can solve the mental health crisis falls flat. As COVID-19-era internet access expansion policies expire, Georgians are left to grapple with the third-worst mental healthcare infrastructure in the nation. Recent telehealth legislation has improved access to care for some; however, Georgia must enact policy to break down the barriers that prevent its citizens from accessing consistent, affordable mental health care.
The most significant barrier to healthcare access in Georgia is its chronically high cost. About 1.2 million Georgians, representing 12% of the population, do not qualify for Medicaid and cannot afford private insurance, leaving them without access to the physical and mental health services they may need. Even for those with insurance, the cost of care remains prohibitive. In 2023, nearly 40% of adults with insurance reported being unable to see a doctor due to high costs.
Telehealth is Georgia’s most promising solution to reducing mental health care costs. A meta-analysis comparing the costs of traditional care to telehealth found that psychotherapy conducted via telemedicine cut patient costs by 39%. This reduction translated to savings of more than $2,000 per person each year without compromising quality of care or patient outcomes.
Recent legislation in Georgia has attempted to expand telehealth access. The Georgia Telehealth Act relaxed restrictions on telemedicine, helping providers serve their patients remotely during the pandemic. Georgia issued waivers that allowed out-of-state providers to offer telehealth services without a Georgia license. However, those waivers expired, cutting many Georgians off from the care they need.
Although telehealth has the potential to reduce healthcare costs, telehealth’s efficacy relies on the assumption that patients have access to reliable, high-speed internet. For an estimated 500,000 Georgians, that’s not the case.
Since the early 2000s, telecommunications companies and internet providers have invested in supplying urban and suburban communities in Georgia with high-speed broadband infrastructure. Between 2020 and 2022, AT&T invested more than $5.3 billion in Georgia’s wireless and wireline network. However, most of that investment was funneled toward infrastructure to increase network speeds for urban areas with prior broadband access.
Meanwhile, Georgia’s rural counties have been left behind. A dismal 2% of Baker County’s 2,800 residents have access to high-speed internet, while in Echols County, that figure drops to 1%. Expanding broadband in rural areas is more challenging and costly due to the vast distances and lower population density, which drives up infrastructure costs and reduces profitability for providers. This has left many rural communities struggling to gain the same level of connectivity available in cities.
Thankfully, policymakers haven’t completely ignored the need for legislative solutions to rural connectivity. The Achieving Connectivity for Everyone (ACE) Act offers grants to communities that invest in expanding broadband infrastructure. In 2019, the legislature passed SB 2, giving Georgia’s Electric Membership Corporations the legal ability to provide broadband services.
Previously, state regulations had confined their operations to electricity distribution. Their expanded role in providing internet connectivity may allow smaller communities to advocate for better local broadband solutions. Small-scale grants and regulatory changes represent steps forward in delivering rural Georgians the access they need, but such measures have not helped realize full, equitable broadband coverage.
Beyond internet connectivity, Georgia faces a critical shortage of healthcare providers, particularly in rural areas. A staggering 97% of rural counties in Georgia are classified as Health Provider Shortage Areas (HPSAs). Ninety of Georgia’s 159 counties don’t have a single licensed psychiatrist. For the thousands of Georgians who live in HPSAs, telehealth could offer a practical alternative—if they had access to it. Unfortunately, the same rural residents who lack access to physical doctors lack the internet connectivity needed for telehealth services.
Georgia’s legislature must enact policies that expand telehealth access in underserved communities. This includes introducing permanent waivers that allow out-of-state providers to practice telehealth in Georgia. Additionally, Georgia must incentivize telecommunications companies to invest in rural infrastructure to guarantee all citizens benefit from expanded development.
The state should allocate dedicated funding to expand broadband access in rural areas and set specific benchmarks to ensure certain communities are reached. Increasing Medicaid eligibility and reimbursement rates for telehealth providers would also make mental health services more affordable for low-income and uninsured Georgians.
Telehealth can become an affordable alternative to in-person care. This practice can revolutionize access to mental health services and provide millions with life-saving care that would otherwise be out of reach. However, this potential will remain unrealized unless Georgia takes decisive legislative action.
Nate Levy is a first-year student at the University of Georgia studying math and economics. He is a member of the healthcare group.