By Theresa Rohr-Kirchgraber, MD
For over a decade, Georgia has known what it takes to support the health and well-being of its people: expanding Medicaid to close the state’s health insurance coverage gap. Forty states have expanded Medicaid, offering their residents access to lifesaving care and bringing stability to local hospitals. Yet Georgia continues to stand by while more than 400,000 residents remain trapped without access to affordable health care, leaving families to face impossible choices between a doctor’s visit and basic needs like rent, gas, and groceries. As a physician caring for my community, I took an oath to “first, do no harm”—but it’s hard to watch this harm unfold when we know there’s a better path forward.
The consequences of this inaction are profound. Too many Georgians are caught in the coverage gap, where they make “too much” for Medicaid, but not enough to afford private insurance. This traps them in cycles of poverty and debt, making it even harder to access the care they need. This is part of why Georgia’s uninsured rate is nearly 14%—the third highest in the country. Physicians see the harmful impacts of this lack of health care every day. We know the importance of preventive care and early screenings to increase someone’s chances of surviving cancer, treating heart disease, and managing diabetes. An early diagnosis can only be lifesaving if people have access to the care they need. When people are left without access to health coverage because they can’t afford a doctor’s visit, they often delay much-needed care.
When I think about this issue, one story often comes to mind: a patient of mine, a woman in her late 40s, discovered a lump in her breast. Without health insurance, she hoped it would go away, and she put off seeking care, believing that a new job—and with it, health coverage—was just around the corner. But the lump grew larger and harder over the next four months. By the time her new insurance kicked in, she was quickly seen and diagnosed, but the breast cancer had progressed to stage 3. The delay in care, caused by her lack of coverage, cost her dearly.
This situation is all too common for Georgians without health insurance, many of whom end up delaying care until they need urgent medical attention. When they finally seek care, it’s Georgia’s hospitals that bear the burden of this uncompensated care, with far-reaching consequences for everyone. Without reimbursement for the care they provide, hospitals face tough choices—like laying off staff or even closing their doors. In Georgia, more than half of our remaining rural hospitals are already financially vulnerable to closure. As these health care options dwindle, access to care diminishes for all Georgians, particularly those in underserved communities and rural areas across the state. This reality directly affects our role as physicians, which is to provide health care. But some Georgia lawmakers are standing in the way.
By refusing to close the coverage gap, lawmakers are leaving billions of federal dollars meant to support our state’s health systems on the table. That money doesn't just sit in a bank in D.C., it's being put to use in other states. By continuing to delay closing the gap, these lawmakers are putting politics over patients, which leads to worsening health outcomes and harm for Georgians. After years of delays and missed opportunities, Georgia has had over a decade to do what’s right and follow in the footsteps of other states that have seen firsthand the benefits of expanding Medicaid. It’s time for Georgia to stop lagging behind and take action.
Closing the coverage gap would allow people to go to their physician instead of the emergency department when they get sick. It would help Georgians get the care they need without the fear and insecurity of mounting medical debt. While the state’s new Comprehensive Health Coverage Commission is finally studying the issue, this progress is long overdue. Lawmakers can no longer afford to wait or take half-measures. It’s time for them to move beyond commissions and act boldly to close the coverage gap—so that no more Georgians have to suffer or wait to receive the care they need. We know that expanding Medicaid is the key to healthier families, stronger communities, and more secure hospitals. Now, Georgia’s leaders must make it a reality.
Theresa Rohr-Kirchgraber, MD, MACP, FAMWA, is the co-chair Health & Public Policy Committee, American College of Physicians in Athens
