Montezuma, Ga. - Democrat Jason Carter trekked to a shuttered middle Georgia medical center Monday to highlight the state's struggling rural hospital network and sharpen his calls for a federal cash infusion for healthcare.

As a GOP ad barrage targets Carter's willingness to expand Medicaid under the Affordable Care Act, the Atlanta state senator redoubled his support for an expansion outside of Flint River Hospital, which shut down most of its medical services last year.

Carter is trying to cast his support for the Medicaid expansion, a prospect that chills many Republicans but polls better with Democrats and independents - as a fiscal necessity. Gov. Nathan Deal, his November opponent, has rejected expansion by arguing it would be far too costly in the long run.

“It’s incredibly important for us to look at the fact that the federal government has $9 million of our tax money they keep every day," said Carter. "There’s $30 billion in expansion funds that we’ve paid – it’s our money and Nathan Deal wants Washington to keep it. That doesn’t make sense to anyone, certainly not here."

Montezuma’s squat hospital now offers only psychiatric services and little else. County officials said they've had to spend more than $800,000 extra on basic healthcare services, such as ambulance costs, to stabilize patients and transport them to nearby regional hospitals.

One official from the remote town of Ideal told Carter it could take up to three hours from a 911 call to a hospital. Another said he worried that the regional unemployment rate, which hovers around 13 percent, will stay stagnant without a hospital. And a county commissioner said he often worries what would happen if a major tragedy struck town.

“Who says there’s not going to be a natural disaster, a train derailment?” said Bob Melvin, the Macon County commissioner.

Deal in March endorsed a plan to keep more struggling healthcare facilities open by allowing them to scale back their services, though it's too early to tell whether the plan is working. Carter, for his part, vows to foster more innovation of healthcare technology and a renewed focus on the plight of rural communities.

When pressed for specifics, though, the Democrat said that expanding Medicaid was a more immediate way to keep rural hospitals afloat.

"The discussion of the Affordable Care Act is the worst of Washington politics. What we need in Georgia is what’s best for our state," said Carter, adding: "There’s no doubt in my mind that nobody wants Washington to keep our tax money – except Nathan Deal."

Even if he won in November, figuring out a way to expand Medicaid is daunting. A law recently signed by Deal gives the state Legislature, firmly in GOP hands, the final say on a Medicaid expansion. Carter said one possibility involves an Arkansas-style "private option" to use federal Medicaid funds to purchase insurance for the poor, though the plan's future remains unclear.

"You’ve seen Republican governors across the country who have found creative solutions for the problems that the state is facing," said Carter. "We happen to have a Republican governor who is not looking for answers."

The event came as the Rural Hospital Stabilization Committee - a bipartisan group of lawmakers and healthcare workers tasked with confronting the problem - met in Atlanta. Carter made clear the timing of his journey was not coincidental.

“You’ve seen the folks who are currently running the state wait for a crisis to take action,” said Carter. “There’s a task force that’s just meeting today on this issue. And that’s too little too late.”