Medicaid, not Medicare, pays for Dorothy Mae Harbin’s nursing home room in Cumming.

Medicaid also pays for Aaron Hartman’s medications, job coach and home aide in Toco Hill.

Without Medicaid, Savannah pediatrician Dr. Ben Spitalnick doesn’t know how he would serve a quarter of the children in his practice, or if he’d even have a chance to: Many of their parents would probably put off doctor visits, pray, then end up at the ER.

In Georgia, Medicaid serves nearly 2 million people with a surprising array of needs. But the sprawling federal entitlement program has grown beyond what its creators envisioned when President Lyndon B. Johnson signed it into law in 1965. It now forms one of the largest pieces of the pie of government spending — thanks in part to the sheer cost of medical care — and Republican leaders in Washington are determined to rein it in.