As a health care provider at the Urban Clinic of Atlanta, a nonprofit organization that works to provide free medical services to uninsured and low income residents in Fulton County, Megan Boissonneault is no stranger to how access to care can change people’s lives for the better.
“I’m thinking of a patient who I have seen regularly, who has gone through a very long health care journey and eventually got the end care that she needed, which was a big surgery,” said Boissonneault. “One of the things she has noticed is now she can be a mom to her children without having this distraction of suffering from her disease.”
The organization offers primary care services like management of chronic and acute illnesses, screenings and treatment of sexually transmitted infections, lab services, and more. According to staff at the clinic, 80% of the patients they serve are Black and 70% are female.
In Georgia, Black and Hispanic residents are disproportionately impacted by the state’s decision to not expand Medicaid, the federal-state health care insurance program that helps pay for health care for low-income people. In 2023, approximately 12% of Black residents and 30% of Hispanic residents in the state were uninsured, while the rate for white residents was about 10%, according to a report from the Kaiser Family Foundation.
Read More: Need Medical Care but Lack Insurance? These Metro Atlanta Clinics Can Help.
As free and charitable clinics work to bridge the health care gap for the hundreds of thousands of Georgians unable to access Medicaid, these organizations face growing challenges. Federal budget cuts to the public health sector, including reductions in Medicaid funding and grants for disease prevention and research, are creating a landscape of rising demand and increased competition for private funding.
“The last time I asked, I think we had something like 700 people on our waiting list just to get in for a visit,” said Boissonneault, as demand at the clinic continues to rise. “So it’s hard because that’s the constant thing in the back of my mind is how do we reach more people? How do we let people know that they are not left out, and they should not be left out of health care?”
Last month, President Donald Trump signed into law the “Big, Beautiful Bill” which cuts billions over the next 10 years from Medicaid. Not only do the federal cuts put hundreds of thousands of Georgians at risk of losing Medicaid, but Georgia is also one of the 29 states where Medicaid payments to hospitals or nursing facilities would likely decrease, according to an analysis by KFF.
Additionally, Georgia could lose around $382 million in federal grants devoted to supporting health departments, hospitals, universities, and nonprofits if the proposed 2026 fiscal year budget is approved, according to a public database put together by fired and retired staff at the Centers for Disease Control and Prevention.
While free and charitable clinics don’t rely on federal funding, larger clinics and hospitals that do use federal dollars may be forced to get more of their funding from private donors, making the funding landscape more competitive and creating more challenges for free clinics to provide care.
Read More: From HIV to Hormone Therapy, Medicaid Cuts Threaten Atlanta’s LGBTQ+ Community
“The concern is because these organizations that have gotten federal money are not going to be getting as much … everybody’s kind of scrambling to look at the different pots that they can ask for money from that they might not have approached before like private foundations and private funders,” said Donna Looper, executive director of the Georgia Charitable Care Network, an organization devoted to supporting free and charitable clinics across the state through funding and advocacy.
Looper said that Georgia has the second-highest number of charitable clinics in the country with around 100, right after Florida — another state that has not expanded Medicaid. As more Georgians stand to lose health coverage, free clinics will continue to try to meet the increased demand, said Looper.
“Their lists are going to grow in terms of either their waiting list or how many people they serve. People will turn to the free and charity clinics for assistance, and so the more people they serve, the more money it takes to serve them,” said Looper.
While the state did provide some support to free and charitable clinics in 2025 — around $1 million, according to Looper — the state’s ability to offer support in the future may lessen depending on how state leaders plan to rework the state budget to make up for the loss of federal funding.
According to The Atlanta Journal-Constitution, based on a July 11 memo sent out to state agencies by Gov. Brian Kemp’s budget office, agencies are being instructed to deduct any money they’ve lost in federal funding from their budgets rather than ask the state to make up the difference.
“While the governor remains committed to meeting the needs of our growing state, conservative fiscal management means prioritizing spending to live within our means and keeping more tax dollars in the pocketbooks of our citizens,” wrote state budget office director Richard Dunn.
At Giving Health, which offers virtual primary care and mental health services, about 56% of their clients are Black and over 60% are female, according to the organization’s executive director, Michael Giglio.
He said that across the board, Georgians facing poverty are going to be the most impacted by these federal cuts, not only in the realm of health care but also food, as funding for the Supplemental Nutrition Assistance Program, or SNAP, is also affected.
In the face of these cuts, Giglio is urging state and community members to band together to support the work of free and charitable clinics so that every resident can have the chance to access medical services.
“There’s no debating the need for the work that we’re doing. We’ve never found anyone challenge the need for the services that we’re providing, and I suspect that’s true of all the other free and charitable clinics that are in this space,” Giglio said. “We’re all looking to provide vital and necessary care to the most vulnerable in our communities, so we can’t lose track of that.”
