Failure to expand Obamacare has been killing us

When compared to the rest of the USA, the state of Georgia is not very healthy (and neither is the rest of the South). We can say this based on specific national health data collected and analyzed by the University of Wisconsin for the Robert Wood Johnson Foundation project entitled “County Health Rankings and Roadmaps.”

For example, premature deaths before the age of 75 for the US as a whole are 6,700/100,000 residents. For Georgia, the figure is 7,500. In fact, the worst rated Georgia county is 16,200/100,000 … nearly triple the national average.

photo of a hypodermic needle filled with the color of money withdrawing from a vile of Medicaid expansion wrapped filled with moneyOther stats show a similar trend, including those using perceptions of health by our citizens. Georgians self-reported poor/fair health at a much higher rate than Americans in general, 19% to 16%. Obviously, one reason for this situation is that Georgia has a rate of medically uninsured (under 65) that is much high than the national average, 16% vs. 11%. This dismal situation is in large part due to the failure of Georgia’s past Governor and legislature to expand Medicaid, although the Feds pick up 90% of the bill.

Looking at Bibb County, Georgia (Macon is the county seat and the home of one of the authors of this story) as an example, we find that the health situation is even worse than the rest of the state. It is ranked 143 out of 159 on statistical health outcomes and 98 on general health factors. Here are some examples in Bibb County of specific measures.

  • Premature deaths: 11,000/100,000 versus 7,500/100,000 for the state.
  • Low birth weight rate: 13% versus 10% for Georgia (and 6% for top performing USA counties).
  • STD rates (as indicated by chlamydia): 800/100,000 versus 570 statewide.

The bottom line is that Georgia is a less healthy state versus the nation … and Bibb is even more unhealthy. Therefore, it can be inferred that the provision of health insurance to more residents will have an even greater impact on Bibb citizens versus the state as a whole.

As opposed to what opponents will tell you, this is not insurance for those who choose not to work. The vast majority of those who would be covered are the working poor, often our friends, neighbors and relatives.

The respected group Georgians for a Healthy Future states that if Medicaid were expanded, an additional 50,000 jobs would be created, mostly private sector. Bibb’s local economy could use the shot in the arm. 

The Macon Medical Center and other local hospitals which serve a disproportionate number of medically uninsured would also cut their bad debt, removing one the key factors for medical price inflation. Also, many of Georgia’s public hospitals are asking for increased public subsidies paid for from local taxes; these can be reduced with lower bad debt.

Which once again leads us to the basic question of why did then Governor Deal and our Legislature ignored the 90% matching funds for Medicaid expansion? Will the new Governor, Kemp, also a conservative, truly expand Medicaid under the waiver he has asked for?

We understand that there is great divisiveness within our nation and our state. But, per survey research, we are the most religious democracy in the world and, objectively, Georgia itself is a very religious state within a very religious nation.

As such, can’t we all agree to do what most other states (and democratic nations) have already done and take of our working poor? Please, take time today to tell that to the Governor’s office, your local State Representative and State Senator.


Author's Note: portions of this piece previously appeared in the Fayette County News.

Image Credit: The photo of a hypodermic needle filled with the color of money withdrawing from a vile of Medicaid expansion wrapped filled with money was taken by © Beanrat68 and licensed by at using the generous donations of readers like you. Oh, and with a bit photoshop work by

Jack Bernard and Dr. Doug Skelton

Jack Bernard And Dr. Doug Skelton

Jack Bernard is the former Director of Health Planning for Georgia. He retired as a SVP with a national healthcare corporation and is a nationally published expert on health reform.
Dr. Doug Skelton is currently the Chancellor of Trinity Medical School of Sciences and was a Georgia district health officer and Dean of Mercer Medical School.