This brief highlights opportunities and challenges for Medicaid programs in providing access to services for depressed mothers. Low income mothers have high rates of untreated depression, posing significant risks for them and their children. Medicaid covers many such mothers and children, and coverage will increase with implementation of the Affordable Care Act (ACA). Emerging opportunities include new approaches to screening and treatment and new federal funding for integrated health care models and patient-centered medical homes. Major challenges include fragmentation between primary care and mental health care systems and provider shortages. The brief provides suggestions for addressing these challenges.