Although Georgia sees some of the worst HIV rates in the nation, many Georgians living with HIV are unable to access health care through Medicaid, the health insurance program for low-income and disabled people. That’s because, unlike in other states, Georgia’s Medicaid doesn’t cover people with HIV. Not only does this lack of coverage translate to worse health outcomes for people with HIV in Georgia, but it is also fueling HIV rates, reports Vice News.

It didn’t have to be this way. In fact, earlier this year, lawmakers passed a bipartisan bill to expand Medicaid coverage to include Georgians living with HIV. Republican Governor Brian Kemp vetoed it, even though the state’s Medicaid program reported a surplus of over $6 billion. Instead, as Vice explains, Kemp is offering his own version of expanded Medicaid. To quality, recipients must work 80 hours a month and not earn over $14,580 a year, which is 100% of the poverty level.

A lot of people fall don’t make enough money to buy federal insurance but make too much to qualify for state Medicaid. “We continue to have roughly half a million people in Georgia that fall into this coverage gap,” Jeff Graham, of the LGBTQ advocacy group Georgia Equality, told Vice.

What’s more, millions of Americans currently on Medicaid are losing their coverage, including in Georgia. During the COVID-19 pandemic, the Families First Coronavirus Response Act forbade states from removing people enrolled in Medicaid, even if they no longer met the requirements. Beginning April 1, in what’s known as the Medicaid unwinding, states resumed regular operations, meaning no more continuous enrollments. KFF, formerly the Kaiser Family Foundation, estimates that between 8 million and 24 million people will lose coverage in the next year.

Medicaid coverage varies from state to state. Most states expanded Medicaid under the Affordable Care Act. The 10 holdouts are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming, which has exacerbated health disparities in the South. As Vice notes, Medicaid is the primary source of insurance for non-elderly people living with HIV.

HIV-related assistance is available through Ryan White programs and the AIDS Drug Assistance Program (ADAP), but experts worry that these programs will become overburdened and that their funding, especially in Republican states, like Georgia, may be cut.

In 2020, Georgia, with 1,977 new HIV diagnoses, ranked fourth in total number of new cases, according to the Centers for Disease Control and Prevention (CDC); California recorded the most HIV diagnoses (3,924), followed by Texas (3,548) and then Florida (3,408). Overall, 57,561 people are living with HIV in Georgia. About 69% of them are Black, 8% are Latino and 17% are white.

For every 100,000 people in the state, it’s estimated that 644 are living with HIV. This compares with a rate of 453 per 100,000 in the South and 382 per 100,000 nationally. Visit AIDSVu.org for more charts and graphs visualizing HIV data, organized nationally, by state and county.

In related news, see “Latinos in Georgia See Rising HIV Rates While Other Groups See Declines [VIDEO].” “As Medicaid Purge Begins, ‘Staggering Numbers’ of Americans Lose Coverage” and “The Medicaid Unwinding Period: A Message for the HIV Community.”