What do Georgia’s candidates for Governor plan to do to improve healthcare?

With five weeks until Election Day, the fight for Georgia’s governorship has landed squarely on a question that rural communities have been asking for years: why does the nearest hospital keep disappearing?

Fourteen rural hospitals have closed in Georgia since 2010. The communities left behind — in South Georgia’s flatlands and the mountain towns to the north — didn’t need a poll to tell them healthcare was broken. But a University of Georgia survey confirmed what those communities already knew: 85 percent of likely voters say healthcare affordability matters to them. A majority want the next governor to make expanding access a priority. That kind of consensus is rare in a polarized state. It’s also a political opening, and both candidates are sprinting toward it.

Democratic nominee Keisha Lance Bottoms and Republican nominee Rick Jackson are offering distinct answers to the same crisis. How distinct, exactly, is what voters are now being asked to sort out.

The Medicaid Fault Line

Bottoms has made full Medicaid expansion the spine of her campaign. Her “CARE Plan for a Healthier Georgia” would extend coverage to Georgians earning up to 138 percent of the federal poverty level, bringing the state in line with the expansion most others accepted under the Affordable Care Act years ago. She has been blunt in her assessment of the current alternative. Georgia’s existing program, called “Georgia Pathways,” she has called a failure — a limited, work-requirement-laden structure that she argues has left too many people uninsured and too many hospitals financially starved.

Jackson, a healthcare executive, is not running against expansion outright. He’s calling it something different. His version — “intelligent Medicaid expansion” — would broaden coverage while preserving work requirements for some recipients. His stated goal is to move more Georgians toward commercial insurance, which he argues is a stronger long-term option than government coverage. On day one of his administration, he has said, he wants to “close the coverage gap.”

The Rural Hospital Problem

Bottoms launched her general election campaign outside a shuttered rural hospital. The choice of venue was deliberate. She has drawn a direct line between the state’s refusal to fully expand Medicaid and the string of closures that have left rural Georgians driving hours for emergency care. Her “Rural Care First Initiative” proposes stabilizing what hospitals remain by expanding services — EMS, mobile health, and telehealth — to fill the gaps left by facilities that are already gone.

Jackson’s platform, outlined in what his campaign calls the “Jackson Action Plan,” pledges to direct new resources toward rural facilities and increase access to rural healthcare. The specifics are less detailed than Bottoms’ initiative, but the acknowledgment is the same: rural Georgia has been left behind, and the next governor needs to do something about it.

For the communities watching this race from South Georgia or the mountains, the question isn’t whether candidates care. It’s whether either of them has a plan concrete enough to stop the next closure before it happens.

Prescription Drugs

Both candidates have acknowledged what Georgians dealing with medical debt and delayed prescriptions already know — drug costs are crushing people. Bottoms’ CARE Plan would create a “Georgia Rx Savings Board” to negotiate lower prices directly. Jackson’s approach focuses on negotiating better pharmacy rates, using technology to cut out the middlemen who drive up costs, and pushing for more prescription drug manufacturing to happen domestically rather than relying on foreign suppliers.

What’s at Stake

Georgians have been sharing stories about delayed care, mounting medical debt, and the particular helplessness of watching a local hospital board up its doors. Rural voters, by most accounts, are the most vocal — and the most politically unpredictable. Healthcare anxiety doesn’t sort neatly by party and the polls show Bottoms and Jackson are in a tight race.

The election is November 3.