Nationwide, 104 rural hospitals have closed since 2005, and more than half of those remaining operate in a financial deficit. According to a 2024 report by the Atlanta Journal Constitution, because of these closures, as well as the rising cost of medical care and insurance, people living in rural America now have a 43% higher chance of dying from otherwise common illnesses. This effect is especially pronounced among women, due to the lack of proper pregnancy-related care.
According to the Georgia Hospital Association, since 2013, 12 rural hospitals have closed in Georgia, leaving a void in critical services and forcing residents to travel longer distances to visit an ER, receive a primary care check-up, or access a specialist. The same report found that 18 of Georgia’s 30 remaining rural hospitals were in danger of closure.
One of the most debated solutions to improve healthcare access in rural areas is Medicaid expansion. Proponents argue that expanding Medicaid would provide insurance coverage to a larger portion of the population, thereby increasing access to necessary medical services and reducing unpaid medical debt, which weighs down cash poor rural hospitals.
According to the Georgia Budget and Policy Institute, expanding Medicaid could insure over 400,000 Georgians, many of whom reside in rural areas. Currently, Georgia is one of 10 states left that have not expanded Medicaid under the Affordable Care Act, a decision that has left many low-income individuals without coverage.
However, political opposition to Medicaid expansion remains strong in Georgia. Critics are concerned about the long-term financial stability of Medicaid and the potential for entitlement abuse. Despite these concerns, data from states that have expanded Medicaid show significant benefits, including reduced mortality rates and improved health outcomes for low-income populations.
As rural hospitals close and healthcare providers become scarcer, telemedicine has emerged as a potential solution to bridge the gap in healthcare access. Telemedicine allows patients to consult with doctors remotely, reducing the need for long-distance travel. In South Georgia, several initiatives have been launched to promote telemedicine.
For instance, the Georgia Partnership for TeleHealth has expanded its services, providing more than 200,000 telehealth encounters annually. Also, during and after COVID, the state allowed telemedicine providers to act much as an in-person doctor’s visit, such as allowing them to prescribe controlled medications.
In the face of these challenges, local communities in South Georgia are taking action. Community health centers, such as those operated by the Georgia Primary Care Association, provide essential services to underserved populations. These centers offer a sliding fee scale based on income, ensuring that financial barriers do not prevent individuals from receiving care.
Additionally, mobile health clinics bring medical services directly to remote areas, further enhancing access. Finally, the non-profit organization CareSource recently invested $5 million to keep rural hospitals open.
Addressing the healthcare crisis in rural South Georgia requires a multifaceted approach. Expanding Medicaid, investing in telemedicine infrastructure, and supporting local health initiatives are all critical steps toward ensuring that all residents have access to the care they need. Political leaders must prioritize these issues and work collaboratively to develop sustainable solutions for all Georgians.
As we move forward, it is essential to keep the well-being of our rural communities at the forefront of policy discussions. Access to healthcare is not just a political issue; it is a matter of life and death for many Georgians.
Drew S. Cagle, Ph.D. is an Assistant Professor of Political Science in the Department of Social Sciences at College of Coastal Georgia. He is an associate scholar at the Reg Murphy Center for Economic and Policy Studies. He can be reached by email at dcagle@ccga.edu.
Reg Murphy Center