A Medicaid expansion would have brought $35 billion in federal dollars into Georgia over 10 years. But Gov. Nathan Deal said no: Medicaid is broken, and the last thing we should do is make it even bigger.

The promise of those federal billions, however, has proven irresistible to many states, even some that are just as conservative as Georgia. Arkansas leaders, for example, took a look at all the poor and unhealthy people in their state, and then they took a look at the boatloads of federal money that would flow in to pay for Medicaid expansion.

But leaders in Little Rock added a free-market twist: send us the money for Medicaid expansion, they told the feds, and we'll give it to the poor for health care. But they won't get Medicaid coverage. They'll get private health insurance on the Obamacare website and have the same coverage as everybody else.

AJC staff writer Misty Williams, who specializes in health care policy and the Affordable Care Act, went to Arkansas to see how – or whether – the so-called private option is working. She also wanted to find out what Georgia could learn from Arkansas' experience. This is the first of three articles arising from that reporting.

Also: a map showing where every U.S. state stands on Medicaid expansion.

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Travelers walk around the baggage claim in the South Terminal at Hartsfield-Jackson Atlanta International Airport on Thursday, Nov. 6, 2025. Atlanta is among the airports where the FAA will reduce flights due to the shutdown, and airports are facing a shortage of air traffic controllers. 
(Miguel Martinez/ AJC)

Credit: Miguel Martinez-Jimenez