Audit finds Georgia’s rural hospital tax credit brings millions but falls short of growing needs

A Georgia tax credit provides millions of dollars to struggling rural hospitals, but it’s not enough to fund growing needs in these communities.

A recent state audit conducted by the Fiscal Research Center at Georgia State University found that Georgia’s Rural Hospital Tax Credit program has generated more than $432 million for rural hospitals since its inception in 2017. The audit also found that the program costs the state nearly $80 million while adding more than $25 million to the economy.

Jimmy Lewis, CEO of Hometown Health, told the Georgia Recorder that the cost to the state is minimal compared to the benefit it brings to rural communities.

“If we don’t provide vehicles like this to preserve economic development in rural Georgia, we’re going to accelerate to a third-world nation beyond anything we can imagine … we’ve got very problematic situations where we don’t have the money,” Lewis said in an interview with The Georgia Recorder. “Again, these hospitals were built in the mid-50s and haven’t been totally upgraded since then, and as a result, we’ve got a real infrastructure problem.”

A recent study by the Georgia Health Initiative found that the One Big Beautiful Bill Act would result in a loss of nearly $626 million of federal funding in rural hospitals. The study also found that 20%, or 91,274 people, of the estimated newly uninsured Georgians will live in rural areas, further increasing the burden on rural hospitals and medical facilities.

Leah Chan, director of health justice at Georgia Budget and Policy Institute, told the Georgia Recorder that although the tax credit helps struggling hospitals, it does not provide enough financing to meet the needs of rural communities.

“I think what this audit shows is that it has generated more than $432 million in support for rural hospitals statewide,” Chan said in an interview with the Georgia Recorder. “So that is certainly a benefit. Again, no one solution is going to fix all our problems, and we need to access additional levers that allow us to draw down additional federal funds and to ensure we can cover more eligible Georgians.”

The Center for Healthcare Quality and Payment Reform published a report in October saying that 21 of Georgia’s 71 rural hospitals were at risk of closure, with 10 of those being at immediate risk.