Health Care Access in Georgia

Georgia currently holds the sixth-highest percentage of uninsured residents in the country, with almost one out of five Georgians lacking health insurance.[1] Even Georgians who currently have health insurance are affected by the state’s infamous ranking. When insured Georgians go to the hospital and are unable to pay, the cost of their visit is largely paid for by the government and insured Georgia due to provider cost-sharing.[2]

Further, in 2019, Georgia ranked 42nd for state health care system performance.[3] The state’s biggest downfall is the affordability and accessibility of its health care, according to the Commonwealth Fund. The fund conducted a study to measure states’ health care system performance throughout the United States, measuring 40 performance indicators, which were grouped into four different categories: access and affordability, prevention and treatment, potentially avoidable hospital use and health habits of residents.[4]

Even Georgians who have health insurance can still struggle to find care. According to the State Office of Rural Health, approximately half of Georgia’s counties lack primary care doctors to care for the entire population.[5] When those residents do have access to primary doctors, they are often unable to afford further care, as Georgia has one of the highest health care costs in the nation. Such high costs are especially a barrier in Georgia, where 40% of the population is considered low income according to national standards.[6] Due to the lack of health care access in these counties, people from rural areas are required to travel to the city to receive care, although Metro Atlanta is also more expensive than most other major cities in the nation.[7]

Further, those who can afford health insurance in Georgia are still being denied coverage. According to the Georgia Insurance Commissioner, Jim Beck, Anthem Blue Cross and Blue Shield, Ambetter of Peach State and Humana have had high levels of complaints due to denied or incomplete coverage, dozens of which the agency have deemed valid.[8]

Georgia’s actions on immigration have also intensified the lack of health care access, requiring state and local verification of the immigration status of individuals applying for public benefits.[9] Due to a new bill, anyone applying for public benefits in Georgia, such as Medicare, Medicaid and Children’s Health Insurance Program (CHIP), must now show proof of lawful immigration status to any health care providers in universities, community health centers or other public institutions. Making prospective patients not seek medical care for fear of being reported to immigration authorities. Not seeking medical care harms all Georgians, as evidenced by the COVID-19 pandemic.[10]

Georgia, however, does have the option to expand Medicaid to cover all nonelderly adults who earn up to 38% above the federal poverty level under the Affordable Care Act.[11] This expansion would allow approximately 684,000 low-income and uninsured adults to receive health insurance through Medicaid; only costing the state roughly $2.1 billion and the federal government, $30 billion from 2014 to 2030.[11] In 2019, Georgia took the first steps to expand health care with legislation to allow the state to seek federal permission to expand Medicaid to people earning up to the federal poverty level.[12] This legislation calls for partial Medicaid expansion, effective in July 2021, that would cover adults age 19 to 64, as long as they work at least 80 hours per month.[13]

Georgians who could gain coverage under Medicaid expansion are those that earn below 138% of the federal poverty level, or about $17,600 for an individual, $23,790 for a family of two and $29,970 for a family of three. It would also extend health care insurance to cover over 155,000 uninsured women, as Georgia ranks among the bottom five states for women’s health insurance coverage. Nearly half of Georgia’s uninsured veterans, expanding coverage to 32,000 veterans and military spouses.[14]

Georgia must expand Medicaid to lower the cost of health insurance for all Georgians. As the country continues to grapple with the COVID-19 pandemic, the need for immediate health care reform has never been more pressing.  Beyond the moral obligation to help Georgians, expanding Medicaid is simply in the best interest of the state. Immediate Medicaid expansion will save lives, accelerate economic recovery and stabilize rural health systems.