Like many neighborhoods in cities across the country, Atlanta’s Old Fourth Ward is changing.

Condo buildings and modern minimalist homes mark the low-income housing block. Many longtime residents of the historic district where Martin Luther King Jr. was born have been slashed and relegated to other parts of town.

The Atlanta Medical Center, a 460-bed Level 1 trauma center, will be transformed next.

A banner declaring the hospital’s commitment to the area — despite saying “120 years of caring for Atlanta” — the nonprofit owner Wellstar Health System recently unveiled on November 1st. announced plans to close the doors of hospitals.

Georgia has closed several rural hospitals over the past decade, but this year Atlanta brought facility closures to other city centers, including an earlier reduction at a facility in the nearby city of Eastpoint. I was.

Wellstar’s announcement sparked political debate over the expansion of Medicaid ahead of the Nov. 8 midterm elections. Georgia, like 11 other states, has not expanded Medicaid program eligibility rules under the Affordable Care Act. Hospital officials across the state say their inaction is hurting their bottom line as they are still treating large numbers of uninsured patients who cannot afford their medical bills. process.

Welster’s announcement shocked city officials and other members of the community, including Mayor Andre Dickens.

On a recent weekday morning, 60-year-old neighbor Teresa Smith said she frequently seeks medical attention for chronic digestive problems. “This hospital will be missed by the whole community,” she said.

Liliana Bakhtiari, an Atlanta city council member for the district that includes the hospital, was astute in her assessment. I will,” she said.

Wellstar declined an interview request regarding KHN’s closure.

Nancy Kane, an adjunct professor at Harvard’s TH Chan School of Public Health, sees a link between the situation in Atlanta and hospital closures in other major cities.

Many were acquired by large healthcare companies as part of package deals, primarily serving low-income minorities.

“If you buy a hospital, you should be obligated to fix it,” Kane said. “Welstar has the funds to invest in this hospital. It’s a choice.”

Some community members believe the hospital closure will lead to expensive real estate development on about 20 acres owned by Welstar nearby.

“It could be a blank slate, either a redevelopment or a new development,” said Randy Pimsler, an architect at the company that designed the area’s project.

Politicians quickly turned the closing into a campaign issue. At the center of the debate is Governor Brian Kemp’s health care policy.

Kemp spokesperson Andrew Eisenhour said Kemp’s team is working to put together a long-term plan to strengthen health care in the region after the shutdown. He is unlikely to try to keep the facility.

However, officials from the nonprofit Grady Health System this week said they were working with Kemp’s office, Dickens, and Fulton and DeKalb counties on an infusion of state funding to support the capital needs of Grady Memorial Hospital, a Level 1 trauma center. said he met with Approximately 1 mile from Atlanta Medical Center.

Grady expects an additional 2,500 emergency room visits a month after the Atlanta Medical Center shuts down.

Grady Health System CEO John Haupert said: Still, additional ER crunches will be a challenge as more patients arrive, said Ryan Rourke, Grady’s chief health policy officer.

State funding will accelerate Grady’s existing plans to convert offices into inpatient care spaces, which will add more than 180 adult beds a year from now. The hospital also said in the next six weeks he plans to add 40 to 45 beds and set up a 24-bed field hospital to handle the patient flow from the closed hospital.

The shutdown puts the expansion of Medicaid “at the forefront and center” of the political conversation, Haupert said. Kemp proposed a limited plan to provide access to state federal insurance programs for those who can meet work requirements or similar obligations.

His challenger, Democrat Stacey Abrams, has long made expanding Medicaid a top campaign priority.

“This is no longer a surprise,” said Abrams. “We expect that to happen because the Kemp administration has refused to take action.”

Senator Rafael Warnock (D-Georgia), pastor of Ebenezer Baptist Church, less than a mile from the hospital, also denounced the closure, citing the pressure on medical facilities due to Georgia’s refusal to expand Medicaid. mentioned the burden. Wellstar officials say Medicaid expansion alone could not have sustained the Atlanta facility.

Earlier this year, Wellstar suspended emergency room and inpatient services at a hospital in East Point, just southwest of Atlanta. At the time, these patients said they could be seen at the Atlanta Medical Center, about eight miles away. Haupert estimates it will cost hundreds of millions of dollars to modernize the soon-to-close Atlanta hospital, making rescue difficult.

Andra Gillespie, an associate professor of political science at Emory University, said Abrams’ call to expand Medicaid resonated with voters, but the shutdown could come just a few months before. “A problem that was probably tailored for rural Georgia suddenly became a problem for the Atlanta area.

Gillespie warned that other issues such as inflation, crime and abortion are likely to be more motivating for Georgia voters.

Based in suburban Marietta, Wellstar acquired AMC and East Point Hospital from Tenet Healthcare during an acquisition push in 2016.

Todd Greene, a former member of AMC’s Wellstar Community Board, said the system will devote more resources to suburban facilities.

“Unfortunately, Welster’s suburban, hospital-oriented management approach has prevented a large portion of Atlanta’s black and brown communities from accessing critical health services in close proximity,” he said in a statement.

Wellstar’s closure announcement said it had invested more than $350 million in facility upgrades since 2016 and “sustained losses of $107 million in the last 12 months alone.” rapid inflation. “

The decision to close the hospital did not come as a surprise to some staff, said Dr. Sulieman Wazeerud-Din, the hospital’s emergency doctor, who said the doctor “was aware of the financial loss.”

But the sudden announcement caused deep grief among doctors, nurses, and other non-medical workers.

Since the announcement of its closure, Grady has provided jobs to a variety of Atlanta Medical Center employees, from doctors and nurses to housekeeping and security staff.

David Patton has lived in Atlanta’s Old Fourth Ward for 30 years and says the Atlanta Medical Center has been a big part of his life.

His grandfather died in an on-campus nursing home and was treated in the ER, and his son took swimming lessons at the hospital’s athletic club. All the while he has seen neighborhoods morphing into one from the “forgotten” part of the city. It has become the lightning rod for new developments.

“It blows my mind that such an institution would shut down virtually overnight,” he said.