When The Atlanta Journal-Constitution’s Politically Georgia team visited the University of Georgia last month, I was excited to hear Gov. Brian P. Kemp speak, but I was disappointed to hear him say he was in the “no camp” on Medicaid expansion.

It’s imperative that Georgians come together to change the governor’s mind. Kemp cares deeply about Georgia and the well-being of Georgians, but he’s missed the mark on Medicaid expansion.

And the stakes couldn’t be higher: For some Georgians, it’s quite literally a matter of life and death.


Expanding Medicaid isn’t just about bringing $3.6 billion of Georgians’ hard-earned federal tax dollars back into the state; it’s about something far more important: saving Georgians’ lives, including Georgia’s mothers and the 71,040 women of reproductive age who would be covered under Medicaid expansion.

Research shows that Medicaid expansion would significantly lower Georgia’s alarmingly high maternal mortality rate.

Georgia ranks 42nd in the nation for maternal mortality, with 28.8 women per 100,000 live births dying while pregnant, during childbirth or 42 days after childbirth. Georgia’s maternal mortality rate is higher than 72 countries, including economically disadvantaged ones such as Chile, Grenada and Iran.

For women of color in Georgia, the situation is far worse, with a rate of 98.4 women per 100,000. A woman in wartorn Syria is less likely to die from maternal mortality than a woman of color in Georgia.

These statistics indicate a grave truth: Georgia has a maternal mortality epidemic. And we, as Georgians, must do something to solve it.

Medicaid expansion is an evidence-based, common sense and proven solution to help end this epidemic. It will save countless mothers’ lives.

Further, Medicaid expansion is essential to the continued existence of Georgia’s rural hospitals.

Since 2010, eight of Georgia’s rural hospitals have closed. In 2024, 18 of Georgia’s 30 rural hospitals are at risk of closure.

Medicaid expansion decreases the likelihood of rural hospital closure by 62%.

These hospitals closing would not only have a significant negative impact on Georgians’ health but also would exacerbate Georgia’s maternal mortality epidemic. With 56 of Georgia’s 159 counties already being “maternity care deserts,” we simply cannot afford another closure.

This year, the Georgia General Assembly debated Certificate of Need reform and Medicaid expansion, culminating in Kemp signing House Bill 1139.

This bill loosened CON permitting for rural hospitals and created the Comprehensive Health Coverage Commission.

Before Kemp signed this bill, the CON regime mandated that hospitals prove a real need before constructing new facilities.

While, in theory, CON intended to reduce health care costs, in practice, it often left communities underserved.

Revising CON rules could allow more health care centers to open, but it doesn’t solve the existing problem of hospital closures. It’s like continually trying to pour water into an already leaking glass. It ain’t a great long-term solution.

Addressing Georgia’s complex health care challenges requires comprehensive solutions.

If we truly want to support Georgia’s rural hospitals and eradicate our “maternity care deserts,” we need both CON reform and Medicaid expansion.

In theory, the Comprehensive Health Coverage Commission will study Medicaid expansion and, more broadly, health care accessibility. It is an essential first step: Compiling facts, bringing stakeholders together and making the case for Medicaid expansion.

But how valuable are its findings when Kemp is already firmly in the “no camp?”

That’s why we, as Georgians, must do something.

I believe that Georgia can and should be, as Kemp says, “the best place to live, work and raise a family.” But to achieve this, we first must make it the safest and most supportive place to start a family by expanding Medicaid and addressing Georgia’s maternal mortality epidemic.

The Healthy Mothers, Healthy Babies Coalition of Georgia is doing important work day in and day out to address this epidemic: Providing comprehensive direct services, educating the community and engaging in collaborative advocacy.

However, Healthy Mothers, Healthy Babies cannot solve this epidemic alone. It needs our help. It needs the General Assembly’s help. It needs Kemp’s help. It needs Georgia’s help.

Medicaid expansion will do more than just address Georgia’s maternal mortality epidemic, but it’s one crucial reason why we must enact it and join the 40 other states that have seen its success.

We can’t just keep kicking the can down the road. Georgians are suffering and dying.

However well-intentioned Kemp is with his Pathways Program, the simple truth is that it’s not working. With only 4,000 of 350,000 eligible Georgians enrolled in Pathways, it’s time for Kemp to change course and support Medicaid expansion.

Although admitting that the Pathways Program hasn’t been successful might be difficult politically, leadership means doing things that aren’t always easy. Leadership is expanding Medicaid.

Together, we can convince Kemp and the General Assembly to expand Medicaid.

Together, our calls, our emails and our advocacy can make a difference. Together, we can make Medicaid expansion a reality and save the lives of Georgia’s mothers.

Marietta native Jacob Hays, a student at the University of Georgia, is the president and cofounder with Adam Szczupak of Georgia for Change, a nonpartisan organization dedicated to advocating for common-sense legislation that betters the state of Georgia and the lives of Georgians.