By John A. Tures, Professor of Political Science, LaGrange College

Will Georgia, one of the last ten states not to expand Medicaid, finally figure out how to do it in a way that appeases Republicans? That’s the question for both parties under the Golden Dome. There seems to be more bipartisanship in favor of the bill. Such an expansion can’t come soon enough, as evidence shows those states which haven’t expanded Medicaid have residents less likely to report being healthier.

According to WABE “Democrats in the state legislature are making another attempt this session to extend health insurance to more Georgians under Medicaid coverage — and this time, four Republicans have already signed on, despite Gov. Brian Kemp making clear he does not back full Medicaid expansion. ‘We believe that this bipartisan legislation can get passed,’ Senate Minority Leader Harold Jones told reporters at a Tuesday press conference.”

Last year, there was some hope for a bipartisan piece of legislation. But the bill died in a Georgia Senate committee. Instead, with Governor Brian Kemp’s support, a smaller program was created in 2020 called “Pathways to Coverage.” But its stringent work and/or volunteer requirements to receive aid have led to only a fraction of eligible people eligible applying for such help. A study by Georgetown University reveals the flaws in the program which is eligible to expire in the Fall of this year.

What was supposed to cover 64,000 Georgians has only managed to enroll 6.25 percent of that number. And North Carolina, with a GOP legislature and Democratic Governor, expanded Medicaid to cover ten times more residents than Georgia was estimated to help, according to Georgetown University.

Georgia is one of only ten states that haven’t embraced Federal funding for Medicaid. Are those states which refuse the money and covering more of their lower income residents doing better, or worse, for their own citizens? To test this, I look at Statista’s “Health in the U.S. States: Statistics & Facts.” Survey data published by John Elflein late in 2024 reveals how many women reported their health as only fair or poor, as well as how many men considered their health only fair or poor.

Of then ten states that didn’t take the Medicaid expansion, women in those states were more likely to report being in only fair or poor condition, compared to states that did expand Medicaid. The results were statistically significant (p<.01). Moreover, five of those states are in the top 12 states reporting the most cases of fair to poor health for women. Of all the states, none which expanded Medicaid is among the bottom 15 for women with fair to poor health.

It’s a similar story for men. Of the ten states that didn’t expand Medicaid, five of them are among the top 12 states for cases of fair-to-poor health for men. The states which failed to expand Medicaid are also more likely to have men report being either in fair or poor health (p<.10), though the relationship is not as strong as it is for women.

The 2020 Medicaid plan could certainly help a state tackle the chronic illness. But will the states, especially red ones, take it? Already you see plenty of GOP-led states, from Arkansas and Louisiana to the Plains and all throughout the country, which agreed to work with the national government on Medicaid expansion. Perhaps the solution is to call it something else, lest some Republicans object to perceiving the coverage of those less fortunate as somehow being considered a “win” for Obamacare.

John A. Tures is a professor of political science at LaGrange College in LaGrange, Georgia. His views are his own. He can be reached at jtures@lagrange.edu. His “X” account is JohnTures2.