He Promised His Dying Mother He’d Protect the Family’s Health. In This Georgia Town, It Isn’t Easy. “Keep the family healthy.” Those were some of the last words Clifford Thomas’ mother said to him. But in Albany, a town with a health care monopoly and no Medicaid expansion, staying healthy is a luxury that many are priced out of.

Clifford Thomas and his family lost four relatives during the COVID-19 pandemic, including his beloved mother, Beverly. A middle school teacher, Beverly had struggled with chronic health problems all her life, and when they forced her to leave her job due to disability, she was unable to afford regular medical care. Her final request to her son was that he keep the family healthy.

But in Albany, Georgia, achieving that promise is a battle. The city is served by a single, dominant hospital system, Phoebe Putney Memorial. Its control of the market and Georgia’s strict limits on Medicaid have left nearly one-third of people in Albany, one of the poorest cities in the state, uninsured.