The cashier checking you out at the local grocery store, the person cleaning your home or the server taking your order at your favorite restaurant – they are all likely toiling without health insurance, according to a new report.

This story also appeared in Georgia Recorder

A new analysis from Georgetown University Center for Children and Families used U.S. Census data to paint a picture of the state’s uninsured workforce as the federal government dangles new incentives for holdout states like Georgia to fully expand Medicaid.

“The folks who make up a significant portion of our uninsured population are people with whom we interact regularly,” Laura Colbert, director of Georgians for a Healthy Future, said in a call Thursday with reporters about the report.

More than one-third of the state’s uninsured low-wage workers hold jobs in hospitality or retail industries, which were the hardest hit during the COVID-19 pandemic. The report, though, relies on 2019 data, which was the most recent available. Many administrative, support and waste management workers were also uninsured.

“Both of these top two sectors employ a clear majority of women,” said the report’s author, Joan Alker. “So we know that women would be very much impacted and supported and helped – women of reproductive age, especially would be helped by this.”

The sweetened deal from Washington, which was packed into the American Rescue Plan, has renewed calls for Medicaid expansion in Georgia, which would extend coverage to low-income adults who do not have children but who bring home less than $17,775 each year.

In Georgia, an estimated half million people – or about 39% of the state’s uninsured adults – could gain health care coverage under full expansion.

The state stands to net about $710 million in two years under the plan, according to the Kaiser Family Foundation. But Georgia GOP leaders have long questioned the eventual cost to the state and they have so far passed on the new incentives. Georgia is one of 12 states that has not expanded Medicaid under the Affordable Care Act.

Instead, Gov. Brian Kemp and other state officials are pressing forward with a plan to slightly expand Medicaid by opening the program up to as many as 50,000 additional people if they hold a job, attend school, perform community service or undergo job training for 80 hours a month.

The governor’s plan was approved last fall under President Donald Trump, but its fate is now uncertain after the Biden administration paused the state’s application over concerns about the strict eligibility requirements. State lawmakers included $76 million in next year’s budget to launch the program this July.

The state’s plan is still pending with the Centers for Medicare and Medicaid Services, which is also reviewing other state waivers. Some Republicans have accused the Biden administration of a broader effort to push holdout states to expand Medicaid.

Alker, the report’s author, said many of the people who would be eligible for coverage if Georgia expanded Medicaid are already working anyway. And she made the case Thursday that health care coverage supports their ability to continue working.

“When you look at who are these folks who would get coverage in Georgia and other states that have expanded Medicaid, generally about seven and 10 of them are working. They’re already working,” Alker said.

“But they’re working as cashiers and cooks and housekeeping staff and they’re not getting insurance through their job. So that means if they have conditions like hypertension or depression, whatever it might be – asthma that is not well controlled because they’re uninsured – it makes it harder for them to work.”

Georgia Recorder is part of States Newsroom, a network of news outlets supported by grants and a coalition of donors as a 501c(3) public charity.

Jill Nolin has spent nearly 15 years reporting on state and local government in four states, focusing on policy and political stories and tracking public spending. She has spent the last five years chasing...