While Georgians may not yet know who will occupy the Governor’s Mansion in January, there is something Georgians know for sure: They want Medicaid expansion.  A recent AJC poll found that 73 percent of Georgians, including 51 percent of Republicans, support expanding Medicaid.

Georgians know that expanding Medicaid will allow those without insurance to finally get the coverage they need and deserve. This is true for all Georgians, but is especially true for women, particularly those that live outside of metro Atlanta.

The state is currently failing its women. Georgia ranks 48th among the states for health insurance coverage for women, with many uninsured women living in the state’s rural areas. Many of these rural areas lack even the most basic reproductive care. Half of Georgia’s 159 counties currently have no OB/GYN practicing within them at all, and 40 percent of equipped labor-and-delivery facilities across the state have closed over the past 20 years. These circumstances have pushed adequate reproductive health care out of the reach of many of Georgia’s women.

The result? Georgia women are experiencing a rural health care crisis. Georgia ranks dead last among the 50 states for maternal mortality; our maternal death rate here in Georgia is seven times more than in the state with the lowest maternal mortality. One study found that Georgia women who must drive more than 45 minutes to get to the closest labor-and-delivery facility were 50 percent more likely to experience preterm delivery and other pregnancy complications than those with shorter drive times. Georgia also has one of the worst rates of unintended pregnancies, with more than 60 percent of all pregnancies being unplanned. The disparity between these outcomes in Georgia and those in neighboring states shows us that things don’t have to be this way.

How can we begin to solve this crisis? Medicaid expansion. While the 38 percent of Georgians currently without access to insurance are distributed across the state, most live in rural areas.  Among states that have expanded Medicaid, the areas that have benefited the most from expansion have been rural, non-metro areas, with insured rates jumping as high as 18 percent.  Expansion would also slow the closure of rural hospitals and labor-and-delivery facilities in Georgia. States that expanded Medicaid saw much lower rates of rural hospital closure and saw significantly improved health outcomes as more rural folks finally had access to care.

Rural women in Georgia are in the midst of a health care crisis.  Whoever our next governor is, that person must listen to the voice of the people and expand Medicaid

Stephen Gurley is a second-year medical student at Emory University School of Medicine.  Originally from the Washington, D.C., metro area, Gurley is pursuing a master’s degree from the Rollins School of Public Health, also at Emory.  He is interested in health policy, refugee and recent immigrant health, health disparities, and social determinants of health.