U.S. Rep. Carolyn Bourdeaux (D-Ga.) said Monday that the health insurance provisions in the social policy and climate change bill pending in Congress would be a “game changer’’ for Georgia.

The $1.7 trillion legislative package, which recently passed the U.S. House, would offer coverage in the health insurance exchange for hundreds of thousands of Georgia residents caught in the “coverage gap.”

These people include Cynthia English, 46, of Albany. She is uninsured and has diabetes, hypertension and sciatica. She gets care at an local charity clinic but needs a sleep study in order to keep a job as a van driver.

“I have to pay for it out of pocket’’ and can’t afford the cost, English said Monday. “I ended up having to leave my job.”

That coverage gap group – in Georgia and the other 11 states that haven’t expanded Medicaid – make too much to qualify for regular Medicaid, but not enough to qualify currently for subsidized coverage in the insurance exchanges, created under the Affordable Care Act.

Bourdeaux, who lives in Gwinnett County and represents a district that includes several northern Atlanta suburbs, has pushed to close that gap in her first year in Congress, calling it “an opportunity and a moral mandate.”

She said at a Lawrenceville press conference Monday that the Build Back Better legislation would represent the “most significant expansion of health care’’ since the ACA’s passage in 2010.

It would provide a Medicaid expansion “workaround” that would offer insurance to poor people through the exchange instead of through Medicaid.  States could not block the coverage expansion because it falls outside of Medicaid, which is jointly funded by the federal and state governments.

An estimated 60% of those caught in that Medicaid coverage gap are Black or Hispanic, according to the Center on Budget and Policy Priorities.

Gov. Brian Kemp and fellow Republican leaders have pushed for federal approval of a Medicaid waiver in Georgia that would extend coverage for poor residents, but only if they work 40 hours a month or fulfill one of various alternative requirements. The Biden administration has so far been cool to those proposed requirements.

Prospects for the Build Back Better bill in the U.S. Senate are difficult to assess. With a 50-50 split in the chamber, the Democrats can’t afford to lose a single vote.

U.S. Sen. Joe Manchin (D-W.Va.) has demanded some changes, including eliminating a new four-week paid family and medical leave program, according to the New York Times.

But Bourdeaux said Monday that she is “very optimistic” that the health care provisions will remain in the bill. Manchin has signed off on those portions of the bill, she said.

Besides the new insurance coverage, other health care provisions would:

** Extend the more generous subsidies for people who buy insurance through the exchange.

** Guarantee a year of Medicaid coverage for eligible women after they give birth

** Allow Medicare coverage for hearing aids.

** Enhance Medicare’s drug benefit

** Provide new funding for long-term care patients to remain in their homes, rather than in nursing homes.

Republicans have been united in opposition to the bill.

House Minority Leader Kevin McCarthy (R-Calif.) has said that Democrats understand how their “big government” policies are hurting America ​but they’re following through with the Build Back Better initiative because they know Republicans will take back the House in the 2022 midterms.

Kaiser Health News and GHN reported last month that the bill would offer coverage to at least 2.2 million people, the large majority of whom are in Texas and the Southeast.

The Kaiser Family Foundation estimates that 269,000 uninsured Georgians are stuck in the coverage gap. But Bourdeaux and others have said it could be 500,000 or more.

Under the current system, Georgians who have coverage pay for the uncompensated care of the uninsured through higher insurance premiums, she said.

Passing the legislation “will save rural health care in Georgia,’’ she added.