OPINION: Georgia’s Rural Hospitals Are on Life Support: Congress Could Pull the Plug

By State Representatives Viola Davis (D-Stone Mountain), Kim Schofield (D-Atlanta) and Sandra G. Scott (D-Rex)

As state legislators, we are issuing a warning following a devastating analysis of Congress’ proposed spending plan. The bill threatens to slash critical Medicaid funding, placing Georgia’s rural hospitals and the families they serve on the brink of collapse.

According to the 2025 Performance Audit of Georgia’s Rural Hospital Tax Credit, rural hospitals received $74.3 million in state-backed donations last year. Despite this funding, $42 million in donations went unspent, often tied up in long-term capital needs. With Congress’ proposed spending plan to cut $540 million in federal support to Georgia’s rural hospitals over 10 years, the situation is becoming unsustainable. While the program is largely compliant with state law, the audit reveals deep inequities in how funds are distributed and who benefits.

Our concerns and key disparities are highlighted below.

Contribution Gaps:

• Donations ranged from just $71,000 to nearly $4 million per hospital.
• Four of the 10 neediest hospitals received less than the average hospital contribution.
• Hospitals in greatest financial need were not prioritized because 98 percent of contributions were “designated” by donors, not based on need.

Use of Funds:

• In 2023, hospitals spent $70.5 million, but $42 million remains unspent, often tied to long-term capital needs.
• Top spending categories: capital improvements (26 percent), operating expenses (22 percent) and equipment (10 percent).
• Meanwhile, rural hospitals serve Medicaid-heavy populations and provide uncompensated care to indigent patients, absorbing the financial losses.

Taxpayer Disparities:

• High-income individuals earning over $700,000 claimed nearly half of all RHTC credits.
• Of the $44.2 million in tax credits claimed in 2023, 66 percent went to individual taxpayers, many of whom are far removed from the struggling communities these hospitals serve.
• Meanwhile, rural hospitals serve Medicaid-heavy populations and provide uncompensated care to indigent patients, absorbing the financial losses.

This is not a political issue – this is a life and death issue. Rural hospitals serve some of Georgia’s most vulnerable communities, many already hanging by a financial thread. Cutting Medicaid now is like draining the IV line from a patient in crisis or on life support.

Four hospitals have already been identified as at risk of shutting down or cutting services due to Congress’ spending proposal:

• Irwin County Hospital (Ocilla)
• Washington County Regional Medical Center (Sandersville)
• Fannin Regional Hospital (Blue Ridge)
• Flint River Community Hospital (Montezuma)committees.