In Atlanta, illness can lead to eviction. Health care reform could prevent it
In safety-net hospitals like Grady Memorial Hospital, we care for Georgia’s most vulnerable patients at their lowest point. An unexpected heart attack, stroke, kidney infection, or chronic illness flare-up can quickly spiral into severe health consequences if they are not treated quickly.
However, the crisis does not end at discharge.
As medical students training in Atlanta, we often witness a second crisis unfold once patients are medically stable: a financial one.
Recently, one of us cared for a patient admitted with a severe leg infection. After several weeks of treatment, his condition improved and he was ready to go home. But as discharge approached, another reality hit. Missed work had led to lost income and jeopardized his employment. He was worried about how much savings he had, how he would pay his medical bills and if he could still afford his apartment.
These stories are not rare. For countless Georgians living paycheck to paycheck, a hospital stay could spark financial instability that could eventually lead to eviction.
Medicare for All could resolve debt crisis
Across metro Atlanta, more than 2,800 people were experiencing homelessness on a single night in 2024, according to the Atlanta Regional Commission and Partners for HOME.
For many people experiencing unstable housing, medical debt is not incidental.
It can be a huge driving factor.
Expanding access to universal health coverage, often discussed as “Medicare for All,” is one way to reduce the risk of homelessness while ensuring every Georgian has comprehensive health care, regardless of income or employment.
A single-payer health care system covers primary care, hospital care, prescription drugs and mental health services, all without out-of-pocket costs.
Universal health coverage could be a powerful tool to prevent the risk of unstable housing and homelessness.
Chronic illness and employment protection
Chronic illness can exacerbate homelessness. In Georgia, conditions like diabetes, heart disease, and cancer can act as profound economic destabilizers when they don’t receive consistent treatment. Over time, these illnesses erode a person’s physical ability to work.
Missed shifts turn into lost wages. Frequent hospitalizations can lead to job termination while medical bills continue to grow.
Nearly 13% of adults in Georgia carry medical debt. When illness reduces someone’s ability to work while expenses continue to rise, eviction can follow.
Preventive care changes that trajectory. Georgia has one of the highest uninsured rates in the country. By providing universal preventive care, early treatment drastically reduces the need for hospitalization. Regular primary care, affordable medications, and early treatment allow people to stay healthy enough to maintain employment and financial stability.
It is far less costly — both for patients and for the health care system — to provide routine insulin for diabetes than to treat kidney failure requiring dialysis. This same principle applies to public health and policy.
Health care stability helps make housing stability possible.
How the current system can lead to homelessness
Georgia is one of 10 states in the U.S. that has not expanded Medicaid, leaving hundreds of thousands of low-income adults without coverage.
For over 5 million working adults in Georgia, health insurance is tied to employment. When a Georgian loses their job, their coverage disappears and preventive care with it. In these instances, people are forced to rely on safety-net hospitals during times of emergencies, yet these hospitals absorb disproportionate amounts of uncompensated care.
Avoidable emergency room visits alone cost Georgia over $710 million in health care spending. For taxpayers in Georgia, homelessness costs around $482 million annually when accounting for emergency health care, law enforcement, shelters, and crisis response teams. In funding these services, public dollars are spent trying to curtail homelessness but fail to address the medical and financial shocks that push families into homelessness.
Housing policy alone is insufficient
Affordable housing policy is essential to addressing homelessness in Georgia, but housing alone cannot solve the problem.
Without comprehensive health care for chronic illnesses and mental health disorders, even the most thoughtful housing programs struggle to succeed.
Housing policies paired with accessible health care are far more durable and improve long-term health outcomes.
In Georgia, lawmakers introduced HB 1480 this spring to establish a state-level Medicare for All program, signaling a growing commitment to tackle both homelessness and health coverage. As medical students, we call on our elected officials to support HB 1480.
In clinics, hospitals, and emergency departments across Atlanta, we see how quickly illness can destabilize a patient’s housing and financial security.
No one in Atlanta should lose their home simply because they got sick. We have the power to change that.
Madison de los Reyes is a fourth-year student at Emory University School of Medicine and plans to pursue a career in primary care for underserved communities in Atlanta.
Gem Johnson is a medical student at Philadelphia College of Osteopathic Medicine (PCOM) Georgia with a strong interest in general surgery and advocating for her patients in Georgia.
Ciara Alvis is a first-year medical student at PCOM Georgia with a strong interest in community health, advocacy, and obstetrics and gynecology.
Hridith Sudev is an onco-epidemiologist and a doctoral candidate in public health at Mercer University.
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