As a lifelong Republican, it is difficult for me to see so many of my fellow conservatives in Georgia casting aside what I believe to be core values of our party — fiscal responsibility, smart policy, and economic growth — when it comes to conversations about Medicaid. We have fallen into a trap of divisive rhetoric, misinformation, and fear mongering that clouds understanding of what this program is really delivering for our state, and what is at risk to Georgia’s economy, state budget, and workforce, if we continue down this path and refuse to expand Medicaid — or worse, roll the program back.
Even if you aren’t one of the 1 in 10 adults or 2 in 5 children in Georgia who rely on Medicaid for health care coverage, you benefit from a strong Medicaid program in Georgia.
1.2 million Georgians lack healthcare coverage, placing an enormous strain on our health care system, particularly for hospitals that end up providing uncompensated care when those millions of Georgians show up needing medical attention. Who ultimately pays for that? Everyday Georgians like you and me.
More uninsured Georgians means that your health insurance costs more, because hospitals raise their prices and shift the cost of unpaid care onto those who do pay. It means businesses pay more to insure their employees. And it means that your property taxes are higher because local governments rely on them to sustain struggling community hospitals. A review of hospital Medicare and Medicaid cost forms reveals that Georgia has roughly $6.2 billion in uncompensated care annually. Georgians like you are footing the bill.
Expanding Medicaid to 138% of the federal poverty level would provide access to coverage to an additional 300,000 hardworking Georgians who currently lack access to affordable healthcare, reducing the amount of uncompensated care.
There are influential voices working to paint an inaccurate picture of who will benefit from Medicaid expansion, but the reality is far different. The people caught in Georgia’s coverage gap are hardworking Georgians — our neighbors, employees, small business owners, people with cancer, veterans, and hourly workers. These folks make too much to qualify for Medicaid, but not enough to afford private insurance, and lack access to employer sponsored insurance. Many are forced to make the impossible choice between continuing to work and risking financial ruin from medical bills, or quitting their jobs to qualify for assistance. As Republicans, we shouldn’t be supporting policies that push people to leave the workforce. If our party continues to buy into misinformation, we will continue to pay the price.
This same misinformation and fear mongering are driving Republicans at the federal level to consider deeply harmful cuts to the Medicaid program and to programs that provide access to private insurance coverage for people on Georgia Access marketplace health plans. Everyday people would shoulder the economic burden of that choice. Depending on the type, Medicaid cuts could result in Georgia losing $8.4 billion in federal funding, putting enormous pressure on our state budget. On top of that, our state would lose an estimated 28,000 jobs, and see a loss of $5.5 billion in economic output in 2026 if Congress does not reauthorize the tax credits that fully subsidize premiums for over 800,000 Georgians on Georgia Access and are currently set to expire this year.
Conversely, expanding Medicaid would be an economic boon to our state. In the first three years alone, closing the coverage gap in Georgia would generate over 150,000 new jobs statewide and increase personal income by $10.8 billion. It would also bring billions of our federal tax dollars back home to Georgia. Medicaid expansion would also help stabilize our rural hospitals, 18 of which are at risk of shutting down in part because they are drowning in uncompensated care.
When Georgia has flexible options for how to close this coverage gap, including expanding access to private insurance, the opposition to Medicaid expansion isn’t conservative—it’s fiscally irresponsible.
Georgia Republicans have the opportunity to rise above the rhetoric and be true conservative leaders by supporting Medicaid expansion for the economic and physical health of our state. Many of our state leaders are ready to close the coverage gap, but they need to hear from constituents like you and me. Call your state representatives today to tell them why this issue matters to you personally, affects your business, and impacts the fiscal and physical health of your community.
Natalie Crawford is the executive director of Georgia First
