On July 3, 2025, Mike Collins of Georgia voted for final passage of the One Big Beautiful Bill Act, after casting one of the votes that passed its House version by one vote (roll call 145). The law requires adults on expansion Medicaid, the primary coverage pathway for people with mental health or substance use disorders, to report work or prove an exemption every six months.
On March 22, 2025, Collins called the creator of DOGE "a genius"; within days HHS canceled grants that DOGE's website dated March 23, including about $1 billion from the federal mental health and addiction agency. In Georgia, HHS cuts led to the elimination of 180 state jobs at the Department of Public Health.
Mike Collins's Votes and Statements on Addiction Treatment and Mental Health Care
- Collins Voted Twice for Medicaid Work Requirements That Reach People in Mental Health and Addiction Treatment, in 2025. On May 22, 2025, Mike Collins voted yes on the House version of the One Big Beautiful Bill Act, which passed 215 to 214, so a switch by him alone would have defeated it, and on July 3, 2025 he voted for final passage. The law requires adults on expansion Medicaid, which is the primary coverage pathway for people with mental health or substance use disorders, to report work or prove an exemption, and to do so again every six months thereafter, starting no later than December 31, 2026. The exemption can only exempt people with “disabling” mental disorders, and many who lose coverage will be people many of whom will remain eligible for Medicaid but who did not successfully complete the paperwork, the Commonwealth Fund found. When Arkansas tried a work requirement, the result was over 18,000 people losing coverage.
- Collins Cast a Deciding Vote for the Budget Plan That Ordered the Medicaid Cut, in February 2025. On February 25, 2025, Collins voted yes on H.Con.Res. 14, the budget resolution, which passed 217 to 215; a switch by him alone would have tied it, and a tie fails. He voted for its final version on April 10, 2025. It instructed the Energy and Commerce Committee, which oversees Medicaid, to reduce the deficit by not less than $880,000,000,000. KFF warns that the resulting cuts, and a more tenuous fiscal climate for states may make those gains harder to sustain, meaning states' recent expansions of mental health and addiction treatment in Medicaid.
- Collins Called the Creator of DOGE "a Genius" in March 2025, as HHS Canceled $1 Billion in State Mental Health and Addiction Grants. On March 22, 2025, Collins posted, "Whoever came up with @DOGE is a genius", and wrote that "We are going to get the 4th branch of government, the federal bureaucracy, under control". DOGE's website then listed grant cancellations to state health departments all dated March 23, Michigan Public reported, and About $1 billion of the national cuts to states’ funding were made by the federal Substance Abuse and Mental Health Services Administration; states had been using the money for programs including programs on infectious disease, mental health, and addiction services. In Georgia, HHS cuts included a $334 million funding cancellation that led to the elimination of 180 state jobs at the Department of Public Health, the Partnership for Public Service reported.
What the Cuts Mike Collins Backed Mean for Mental Health and Addiction Care in Georgia
- Addiction treatment. Georgia's Medicaid program, which was never expanded, covered 10,202 adults diagnosed with opioid use disorder in 2021, according to KFF.
- Federal support staff. The federal Substance Abuse and Mental Health Services Administration, which sends grant money to Georgia, has shrunk by more than half to about 400 people since February 2025 after losing all 10 regional offices and the Office of Treatment Services, Roll Call reported.
Frequently Asked Questions About Mike Collins on Mental health and addiction
What is Mike Collins's record on mental health and addiction under Trump?
Mike Collins of Georgia voted for the 2025 law that requires adults on expansion Medicaid, the main coverage route for people with mental illness or addiction, to prove work or an exemption every six months (roll call 190), and cast a deciding vote for the budget plan that ordered the Medicaid cut (roll call 50). He praised DOGE in March 2025, as HHS canceled about $1 billion in state mental health and addiction grants.
Are people with addiction exempt from the Medicaid work requirements Mike Collins voted for?
Partly. The law Mike Collins voted for exempts people with a substance use disorder or a disabling mental disorder, but they must prove it again every six months, and the exemption reaches only “disabling” mental disorders.
What happened to federal addiction grants after Mike Collins praised DOGE?
Mike Collins praised DOGE on March 22, 2025, and DOGE's website then listed HHS grant cancellations dated the next day, including about $1 billion from the Substance Abuse and Mental Health Services Administration. In Georgia, the cuts included a $334 million cancellation that eliminated 180 jobs at the Department of Public Health.
Last updated: 2026-10-25