The South is home to 11 of the 12 worst states for healthcare , with Georgia ranking 44th nationally. Georgia has a high uninsured rate of 13.4%, affecting approximately 1.4 million residents, making it the third-highest in the country. This lack of coverage, high healthcare costs, and low minimum wages pose economic barriers for residents to access and afford healthcare.
While Democrats aim to address these issues, Georgia's Republican-controlled government resists practical Medicaid expansion efforts. Georgia is among twelve states declining full Medicaid expansion under the Affordable Care Act (ACA), which could reduce the uninsured population by 30%. Governor Kemp's limited expansion plan offers less coverage than the state-federal Medicaid program and imposes work requirements for eligibility, despite most recipients being unable to work due to school, caregiving responsibilities, disabilities, or illnesses. Meanwhile, states that adopted the ACA’s Medicaid expansion have seen reduced uninsurance rates, decreased medical debt, and more access to routine care.
Rising Maternal Mortality Rates
Maternal mortality is a critical concern in Georgia, with pregnancy-related deaths rising and at averaging 30.2 deaths per 100,000 live births. These deaths generally occur due to complications within a year after pregnancy. Shockingly, 89% of the deaths between 2018 and 2020 were preventable, and 60% of them were insured by Medicaid when they had their babies. Bias and discrimination played a role in 15% of deaths, while mental health issues and substance abuse contributed to 18% and 13%, respectively. Likewise, although mortality has doubled for women of all races in the past 20 years, more than half of the deaths were among Black women.
Georgia’s rural communities face significant challenges. Specifically, 35% of Georgia's counties are considered maternal care deserts, which are places lacking hospitals/birth centers for obstetric care and sufficient obstetric providers. Georgia’s physician shortage makes matters worse, as small rural hospitals are unable to offer competitive salaries in the same way metropolitan areas can, making recruitment challenging. Dr. Joy Baker's story exemplifies the dire situation in rural Georgia, where 79 out of 159 counties lack a single obstetric provider. She is one of two OB/GYNs covering an extensive rural region spanning eight counties and 2,714 square miles. On average, her patients travel 40 miles and often rely on a Medicaid van, known for being unreliable, while the most at-risk patients video chat with Atlanta-based specialists.
A Post-Roe Georgia
The overturning of Roe v. Wade will have profound consequences on reproductive health. Abortion bans, like Georgia's HB 481, which restricts abortion after six weeks, jeopardizes women’s safety and forces them to seek healthcare out of state or undergo unwanted childbirth. These bans disproportionately impact marginalized communities, including low-income, Black, and LGBTQ+ individuals, already grappling with a biased healthcare system. Abortions after six weeks account for 88 to 95% of all abortions. If this bill remains in effect, we can anticipate increases in maternal mortality (by 18%), infant mortality, and self-harm behaviors. Additionally, states with restricted abortion access often experience declines in qualified healthcare professionals willing to practice.
Republicans’ eventual agreement to expand Medicaid for up to one year postpartum in 2022, while restricting abortion access, highlights inconsistencies in their approach to healthcare and reproductive rights. While they recognize the challenges faced by pregnant individuals, they also limit their reproductive choices, especially for those navigating complex health or personal circumstances. This juxtaposition stresses the need for a more comprehensive and consistent approach to healthcare. By electing more Democrats to office, we can begin to implement policies that work to improve the well-being of all Georgians.