ATLANTA, Ga. (Atlanta News First) — In much of southwest Georgia, getting to a doctor can mean driving miles down a two-lane road with no stoplights in sight.

Outside a small clinic in Fort Gaines, license plates from Georgia and Alabama tell the story. Some patients travel 30, 40 or even 60 minutes just to see a physician. Inside, Dr. Karen Kinsell keeps working.

At 70, Kinsell works 12-hour days caring for patients in an area with some of the worst health outcomes in the state, according to census data.

“This is the best job in the world,” Kinsell said. “You get to walk into people’s lives every day — their ups, their downs — and it’s the most wonderful privilege I could imagine.”

Fort Gaines and surrounding communities have seen repeated hospital closures. Three nearby rural hospitals have shut down in recent years, leaving patients with limited access to specialty care or emergency treatment during serious illness or injury.

For many residents, access to care means considering more than just the price tag; it’s also about accessibility.

“I don’t have transportation,” said a patient in rural southwest Georgia. “They don’t listen. They don’t even know where Abbeville is.”

Now, a major federal investment could bring some relief.

Georgia is set to receive $218.8 million in the first year of a new, five-year federal Rural Health Transformation Program administered by the Centers for Medicare & Medicaid Services. The funding is part of a $50 billion national initiative created under H.R. 1, commonly referred to by supporters as the “One Big, Beautiful Bill.”

Gov. Brian Kemp announced the award this week, calling Georgia’s first-year allotment one of the largest in the nation.

“This funding will help move us forward in strengthening our rural providers while bringing cost-saving innovations to the state’s health system,” Kemp said in a statement. He also credited the Georgia Department of Community Health for submitting what he described as a strong application.

The funding, known in Georgia as the Georgia Rural Enhancement and Transformation of Health program, is intended to support telehealth expansion, workforce recruitment and training, infrastructure upgrades and new models of care delivery tailored to rural communities.

Dr. Dean Burke, commissioner of the Georgia Department of Community Health, said the state sought public input while developing its application.

“Different rural communities have different needs,” Burke said. “This funding will allow us to advance transformation by supporting rural residents to live longer, healthier lives with access to more effective and higher-quality health care.”

A spokesperson for the Department of Community Health said the agency is committed to working with hospitals and rural communities to ensure the funding is used in accordance with federal guidelines and leads to meaningful transformation. Additional details on implementation and next steps are expected early next year.

However, rural hospital officials and doctors worry the funding will benefit large health systems, leaving hospitals already on the brink of closure without enough support to survive.

“People don’t understand — the doomsday scenario we keep talking about?” Kinsell said. “It’s already here.”

The Georgia Hospital Association welcomed the creation of the Rural Health Transformation Program, saying it reflects growing recognition of the challenges facing rural hospitals and providers.

In a statement, the association said Georgia’s first-year award includes initiatives that could provide a meaningful boost to rural health care, particularly through technology upgrades, workforce investments and improved connections between patients and providers.

Hospital leaders cautioned, however, that the funding is time-limited and not designed to support daily hospital operations.

“These grant funds will not fund ongoing operations,” the association said. “Hospital financing is a delicate puzzle.”

The funding arrives as rural providers face mounting financial pressure. Rural hospitals rely heavily on Medicaid reimbursements, and hospital leaders say future cuts tied to H.R. 1 will reduce other Medicaid program funds that support a broad range of needs, including operations.

At the same time, Affordable Care Act insurance subsidies are set to expire, and health policy experts expect more Georgians to lose coverage — potentially increasing uncompensated care at hospitals already struggling to stay open.

The Trump administration has described the Rural Health Transformation Program as an effort to move away from the existing system and build new, more sustainable models of care. Critics argue the funding is temporary, while the underlying challenges facing rural hospitals are long-term.

“People are going to die because of this,” Kinsell said. “People who could have been saved.”

CMS officials say funding will be distributed over five years, with states expected to begin implementing approved projects in 2026. Final details on which portions of Georgia’s application have been funded have not yet been released.

For communities across rural Georgia, the question is no longer whether the money could help — but whether it will arrive in time.

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