Fourteen years ago, three people started a conversation about a healthier Atlanta. Now more than 200 organizations are part of it, and at the halfway point of its 28-year plan, the coalition is asking what it is still missing.
At the Atlanta Regional Collaborative for Health Improvement’s (ARCHI) recent State of Metro Atlanta Health conference, more than 300 leaders filled the Loudermilk Conference Center to celebrate the midpoint. ARCHI’s partners come from housing, education, healthcare and other sectors, all united by one idea: “The conditions that create opportunities are the conditions that create optimal health,” said Milton Little, president and CEO of United Way Atlanta and one of ARCHI’s founding figures.
The mood was celebratory, but the conversations in each room had a different focus. In one, lawmakers and health leaders discussed the political environment taking shape, and what it might mean for policy decisions on the horizon. In the next, nonprofit leaders and healthcare professionals focused on the long-standing barriers that new policies alone can’t fix.
The first was a breakout panel titled “From Policy to Possibility: The 2026 Midterms & the Future of Health in Georgia.”
Rep. Michelle Au (D), a practicing physician who represents District 50, said the political ground has shifted in Democrats’ favor after the Midterms, and federal limits on health coverage could be revisited. She singled out H.R. 1, the 2025 federal tax and spending law known as the One Big Beautiful Bill Act, which the Georgia Health Initiative projects could cause roughly 32,000 Georgians to lose Medicaid coverage by 2034.
“My assumption is that there will be some scrutiny on that bill, if not an outright repeal,” Au said.
She also sees an opening for the Georgia General Assembly to expand Medicaid, now that Democrats have won majorities in both chambers.
But neither a repeal nor an expansion would bring immediate relief. Ryan Loke, chief health policy officer at Grady Health System, warned that the wait could be long.
“I really think that we’re looking at January 1st, 2028, in the best-case scenario,” Loke said.
Until then, he urged community members and organizations to keep speaking with their representatives and advocating for change.
At “The Power of Belonging, Opportunity & Community Voice” panel, speakers focused on a gap that legislation alone can’t close: the distance between organizations and the communities they serve. Closing it, they said, starts with community input.
Kellie Bryson, one of the panelists, has experienced homelessness herself. Today, she works to get young people with that same experience onto advisory boards that design programs to end youth homelessness. A research director at Point Source Youth and a member of ARCHI’s steering committee, she told the room that many organizations are afraid to meaningfully collaborate with the people they serve because they fear losing funding. The result, she said, is distrust that runs both ways.
“Organizations don’t trust the people that they’re serving,” Bryson said, “and the people don’t trust the organizations either.”
“The only way to genuinely respond to the unique needs of an individual is to bring them to the table and ask them what they need,” she added. “Ask them how you can best serve them.”
Bringing people to the table also requires a shift in how service providers perceive the communities they serve. Dr. Stan Sonu, a physician who specializes in trauma-informed and equity-centered care, said it is important to understand the conditions behind unequal outcomes without defining people by their hardships.
“Our narrative is not our trauma,” Sonu said. “If we shift to that mindset, we do people a greater disservice by approaching them with this pejorative perspective.”
Between the two panels, the picture was clear. A new policy environment, including the prospect of expanded Medicaid, could open new possibilities, but organizations can’t create conditions for opportunity without committing to real collaboration with their communities.
Joy Calloway, president and CEO of Black Women’s Health Imperative, closed the day with a keynote on who carries the burden of changing those conditions.
“We cannot continue to ask individuals and families to demonstrate extraordinary resilience in the face of conditions that institutions have the power to change.”
Institutions need to offer more than an invitation to the table, she said. True partnerships are ones in which people are “not merely invited to participate in the process, but are empowered to shape the process.”
She left the leaders in the room with a challenge: to consider what they would have to give up to make that happen.
“Let us continue to challenge the status quo and continue to exercise discipline, to work across sectors, even when it costs us something. Let us exercise humility, to listen to our communities. Let us exercise leadership, to share power. Because we have the talent, we have the entities, the resources, the knowledge, the relationships; we have everything we need right here in this room.”
She ended on a borrowed line, one she credited to singer John Legend.
“We are the ones we’ve been waiting for. So that means we can stop waiting.”
The room rose to its feet.
