The most recent Annual Survey of Hospitals published by the American Hospital Association (AHA) shows the first drop in uncompensated care since 2001. Although uncompensated care numbers made up 5.3% of total hospital expenses in 2014 (the most recent year total figures are available), that percentage is down from 5.9% in 2013. In dollars, that represents a drop from $46.4 billion in 2013 to $42.8 billion in 2014.

The U.S. Health and Human Services Department attributes this drop in uncompensated care to Medicaid expansion in 31 states across the country. A total of 19 states are not planning to expand Medicaid right now, including Georgia; however the Georgia Hospital Association endorses Medicaid expansion as does the 7,000-member Medical Association of Georgia.

Physicians in the Medical Association of Georgia who voted to endorse the expansion added the caveat that the state should use the Medicaid money to purchase private insurance for the poor in Georgia on the Health Insurance Marketplace. The State of Arkansas has implemented such a program. Because Medicaid payments are often less than the cost for providing care, many physicians across the state have stopped accepting Medicaid patients, reducing the number of providers available for the state’s poor and uninsured.

Proponents of expanding Medicaid to thousands of residents in Georgia who would otherwise fall into the uncompensated care category have made their voices heard at the capitol, but Governor Nathan Deal is opposed to expanding the program due to long term costs. He is leaning toward a waiver program in which the federal government would provide more Medicaid money for Georgia’s rural hospitals as well as Grady Memorial in Atlanta. Members of the Georgia Legislature in large numbers support Deal’s approach.

Since 2001 eight Georgia hospitals have closed their doors and another dozen are in danger of closing in the near future. An answer to the question of how to provide coverage for the currently uninsured in Georgia, and further reduce the uncompensated care numbers, remains a huge debate among healthcare professionals, medical facilities and government officials.