By Senator Michelle Au
The Republican majority loves to note that Georgia is “the number one state for business,” and frequently touts what it views as its success in building up our state’s economy.
However, “the economy” does not exist in isolation in the larger ecosystem of a state where people live, work, and raise families. And what Republicans fail to note is that their extreme positions on a number of healthcare positions has severe consequences on the state’s financial outlook.
Georgia is one of only 12 states in the nation that have still refused to fully expand Medicaid under the provisions of the Affordable Care Act, and as a result, we have one of the highest uninsured rates in the nation.
While our Republican majority has proposed paltry partial measures addressing this gap in coverage (even calling them “half-measures” is too generous as these proposals cover far fewer than half of what full Medicaid expansion would), at this point it is unavoidable to note that GOP partisan intransigence on the issue is having real and lasting economic effects on this state.
We can see these effects daily. In the past decade, 8 rural hospitals have closed, due in part to the high burden these hospitals bear due to uncompensated care—that is, care hospitals are legally bound to deliver even when patients lack health insurance. Two other metro Atlanta hospitals, including the 460-bed Atlanta Medical Center, are set to shutter in the latter half of 2022.
With these hospital closures comes a loss of jobs, a deterioration of the healthcare safety net in lower-income areas where the economy is already struggling, and a decreased ability to recruit businesses and the necessary workforce to these areas.
Nor is this economic effect isolated to residents of these areas or patients who might qualify for Medicaid. Patients with private health insurance concomitantly see their healthcare costs rise as healthcare systems attempt to make up for the losses due to uncompensated care. And higher uninsurance rates make for a sicker and less productive workforce. One study found that uninsured workers, who have more barriers to health maintenance, missed nearly five more days of work annually than those with insurance. Such health-related losses in productivity reduce U.S. economic output by an estimated $260 billion per year.
While Republicans insist that we cannot afford to expand Medicaid, it becomes increasingly difficult to explain how we can continue to refuse.
Georgia has one of the most restrictive anti-abortion laws in the country, which criminalizes abortion care after approximately two weeks after a first missed period, before many women even know that they are pregnant. This law criminalizes patients and healthcare providers for providing best practice medical care, and will lead to delayed and denied care for women—even those who are not pregnant—and worse health outcomes in a state that already has among the worst maternal mortality figures in the nation.
Abortion access is an economic issue, and the overturn of Roe v. Wade in states enforcing extreme anti-abortion laws is “an economic catastrophe for millions of women.”
In a state where women already face an environment of lower wages, diminished worker power, and lack of access to healthcare, restrictions to abortion access deal yet another blow to economic security and mobility for nearly half of Georgia’s workforce. A landmark study shows that denying women access to abortion care creates economic hardship that lasts for years, increasing the chances that these women would live in poverty, be unable to cover the cost of basic living expenses, and suffer bankruptcies or eviction.
Further, extreme anti-abortion laws create an unfavorable business environment, as some of the country’s biggest businesses (including JPMorgan Chase, AT&T, and the Walt Disney Company) have registered that they will invest in travel expenses for members of their workforce who can not get the abortion care they require.
Republicans tout GA as “the #1 state to do business and in which to raise a family.” Robbing women of reproductive choice means we are neither.
Gun violence is a public health crisis. Georgia has some of the most lax gun safety laws in the nation, and this has a substantial and lasting economic impact.
Per a 2019 Congressional study, 1,459 Georgians a year die from gun violence—approximately one death every six hours. The annual cost of gun violence in Georgia is $7.9 billion, and includes direct calculated costs such as lost income and spending, employer costs, police and criminal justice responses, and the cost of health care treatment. Gun violence is also associated with fewer jobs, lost businesses, and lower home values. Georgia's enthusiastic support for “more guns everywhere” hurts our economy and has direct financial costs on everyone living in this state.
Further, the state’s permissive approach to gun safety disincentivizes businesses and events from coming to Georgia. Most recently, Music Midtown, a major annual event in Atlanta, was canceled in response to Georgia’s gun laws, which precluded the organizers from being able to prohibit attendees from carrying loaded guns into the crowded festival. This cost the city an estimated $50 million dollars in lost revenue. There is no reason to think that other such events will not avoid Georgia for similar reasons.
Our Republican leadership no doubt has ideologic reasons for taking the positions they do on this wide range of healthcare related issues, but we cannot continue to ignore that these positions come at an economic cost, and these costs are borne by each and every one of us.
And it’s time for the GOP, who brands itself as the fiscally conservative party, to consider how much Georgians are spending to pay for their reckless health policy decisions.
Michelle Au, MD/MPH is a practicing physician in metro Atlanta and a Georgia state senator. She and her family live in Johns Creek, GA.