Dec 14, 2020
ALBANY, Ga. -- Georgia's rural hospitals are struggling financially. Since 2010, at least nine have closed, including two this fall, and others are at risk.
In addition to a lack of federal COVID relief since March, Georgia is one of 12 states that have opted not to expand Medicaid under the Affordable Care Act (ACA) to households with incomes below 133% of the federal poverty line. Laura Colbert, executive director of Georgians for a Healthy Future, said because Georgia's uninsured rate is so high, rural hospitals are tasked with providing uncompensated care to many patients who are unable to pay. "What we've seen in other states is that Medicaid expansion has really benefited rural hospitals," Colbert contended. "And also community health centers by giving them more insured patients, thus giving them a stronger financial footing and a more predictable financial footing." She added in some cases, rural hospitals are the largest employers, so closures can have profound impacts on the local economy as well. Shakya Cherry-Donaldson, executive director of the group 1,000 Women Strong, said in her rural area of southwest Georgia, where the population is predominantly African-American, even folks lucky enough to have a job and be fully insured may have to travel far to see a doctor. "Women are having to drive over an hour to get an OBGYN in order to see someone," Cherry-Donaldson observed. "And you know that on top of the pandemic, on top of just the reality of Black women and maternal mortality, I mean, everybody is on pins and needles." If states fully expand Medicaid under the ACA, the federal government funds 90% of the costs. But that doesn't apply to Georgia's partial expansion plan, with an added work requirement, which goes into effect in 2021. Colbert noted while Republican Gov. Brian Kemp and other GOP lawmakers have expressed concerns about the cost, their plan won't maximize cost efficiency. "The governor's plan for a partial Medicaid expansion will cover one tenth of the people and cost about as much as a full Medicaid expansion," Colbert argued. Expanding access to health insurance has been a key issue in Georgia's Senate runoffs. Democrats Jon Ossoff and Raphael Warnock support Medicaid expansion, while Republicans David Perdue and Kelly Loeffler both voted in support of President Trump's attempts to repeal the Affordable Care Act.