The nonpartisan Commonwealth Fund rated health care in states across 42 areas from 2007 to 2012 in a report titled Aiming Higher: Results from a Scorecard on State Health System Performance 2014.
All states improved in some areas, such as childhood vaccination, but more than half declined on at least nine of the measures, according to the report.
Compared with a ranking from 2009, Georgia’s standing plummeted. Its overall ranking fell from 35th to 45th. It dropped from 22nd to 48th in health care for minorities and did decidedly worse overall in how it treats vulnerable populations – the poor and minorities – compared to the population as a whole, falling from 27th to 46th.
In the rate of uninsured black and Hispanic adults younger than 65, Georgia ranked 49th, ahead of only North Carolina and Tennessee, in a list that includes the District of Columbia.
The state was at the bottom in measures looking at minority at-risk adults who went without a doctor visit, minority children without a medical home and minority children who had not had a preventive care visit in the past year.
Georgia is near the bottom in similar measures for the poor. The uninsured rate grew overall during that time period but was particularly bad for some, said Commonwealth President David Blumenthal.
“Those rates grew faster in some places than others, and the costs of care were going up so that people without insurance found it harder to afford what care was available,” he said. “This was a difficult period that was exacerbated in some locales more than others.”
Those groups clearly lost ground in Georgia, said Commonwealth Fund Senior Vice President Cathy Schoen.
“We’re seeing for vulnerable groups an increase in not being able to go to the doctor, being uninsured, not getting preventive care,” she said.
In many measures in the report, the gap in rates between the best-performing states and the worst is as much as two- to eight-fold, the report authors note.
Georgia is one of 16 of the worst-performing states that will also not expand Medicaid under the Affordable Care Act, the report found. Doing so would have extended insurance coverage to adults up to 138 percent of the federal poverty level, Blumenthal said. And that has a real potential to improve care over time, Schoen said.
“There is a real opportunity to not just expand to the lowest income population with insurance but keep them securely insured so that they have continuity of care over time,” she said.