Are Georgians More Financially Burdened Than Other Americans? A Georgetown Index Provides Answers

Health care and food take a bigger bite out of Georgia budgets than they do nationally, while housing and child care land closer to the national share.

The numbers come from a Georgetown University study, and the researchers say the hardship reaches well above the poverty line.

Here’s what the study found, how Georgia compares with other Southern states and why Medicaid expansion shows up in the results.

Note: This is general information, not medical or financial advice. Health coverage costs and program rules are subject to change.

Who Ran the Index and How

Georgetown University Law Center ran the index. It’s called the Family Economic Well-Being Index.

It was released in September 2026. It uses 2023 answers from the Census Bureau’s American Community Survey.

That survey collects answers from a sample of households across the country.

The index looks at housing, food, health care and child care.

For each cost, the index asks what share of your household’s take-home pay the need would take up.

The groups are doing fine, getting by, burdened and severely burdened.

In this article, the health care, food and housing percentages add up the burdened and severely burdened groups.

They count people.

The child care figure counts households with a child under 6.

You can read the full methodology on the center’s site.

Health care and food are the two costs where a larger share of Georgians than Americans overall is burdened.

Health care comes first.

Health Care Costs

Across the U.S., health care costs severely burden 26% of people.

Another 15% are burdened.

In Georgia, those two groups add up to 48%. Across the U.S., they add up to 41%.

Here’s what that looks like.

Say your household takes home $60,000 a year after taxes.

Health care costs become a burden for you once they pass $6,000 a year.

That’s $500 a month.

Both the premiums you pay and your out-of-pocket costs count.

Food Costs

The Georgia Recorder reported that food costs burden 36% of Georgians.

Across the U.S., the share is 32%.

The index prices groceries with the Department of Agriculture’s Low-Cost Food Plan. It assumes meals cooked at home.

Say your grocery bill on that plan is $12,000 a year. Food becomes a burden once your take-home pay falls under about $66,700.

Southern States Compared

Texas and Mississippi have the highest health care burdens, at 50%. Oklahoma is next at 49%, then Alabama and Georgia at 48%.

Health care burdens are highest in the South.

Food burdens rank differently.

Mississippi is highest at 43%.

Louisiana and Alabama follow at 40%, and Hawaii and Oklahoma are at 39%.

If you live in Georgia, your state is among the five highest for health care burden but outside the top five for food.

Medicaid Expansion

Health care burden tracks with Medicaid expansion. None of the index's highest-burden states except Oklahoma have expanded it.

Georgia is one of the highest-burden states.

The Georgia Recorder said that many Southern states chose not to fully expand Medicaid.

In those states, a higher share of people reported health care cost concerns.

Danilo Trisi, one of the index's researchers, said states that didn't expand Medicaid have higher insurance costs.

That's why more of their people are burdened by health care costs.

Beyond the Poverty Line

Lelaine Bigelow, the center's executive director, said hardship reaches deep into the middle class.

The Recorder reported that in Georgia, as many as 70% of people struggle to afford basic needs.

That means things like food, housing, health care or child care.

Look at the middle fifth of incomes nationwide. Nearly half of that group faces a health care burden.

Housing and Child Care

Housing and child care are the two costs where Georgia isn't above the national figure.

News coverage of the report put housing burden at about one-third of Georgians.

That's close to the national share.

Nationwide, more than one-third of people are burdened by housing costs.

Child care is the one cost where Georgia comes in below the national figure.

If you're raising a child under 6, that's the group this figure covers.