On February 3, Rick Jackson held a press conference at his company’s Italian-inspired Roman Colosseum headquarters in Alpharetta to announce his decision to run for governor of Georgia. The healthcare staffing entrepreneur, who is running as an outsider who will cut taxes, crack down on criminal illegal immigrants and fix the health care system, has no experience in politics. What he does have are survival instincts, a rags-to-riches story and a fortune to spend. Forbes estimates that the 72-year-old -- who lives in a more than 35,000 sq. ft. home with at least 7 bedrooms, 20 bathrooms and 72 acres in Cumming, Georgia -- is worth at least $1 billion. So far he’s already dropped at least $50 million on ads touting his climb from foster care to financial success and says he’ll spend double that amount.

“If there’s one thing he’s proven, it’s that you can buy a third of the Republican primary vote,” says Dr. Charles S. Bullock III, a political scientist at the University of Georgia, following Jackson’s surprising win on May 19 to secure a spot in the June 16 Republican runoff pitting him against Trump’s pick, Lieutenant Governor Burt Jones. Most polls show Jones prevailing by a couple points over Jackson; the winner will face former Atlanta Mayor Keisha Lance Bottoms in November.

Don’t count Jackson out. After all, he’s overcome worse odds to build one of the biggest private companies in America – $3 billion (revenue) medical conglomerate Jackson Healthcare, which operates 22 healthcare companies – each with its own management team – and places thousands of doctors, nurses and anesthesiologists in hospitals nationwide.

According to William Blair analyst Trevor Romeo, Jackson is the nation’s second biggest company in medical staffing — behind Suffern, N.Y.-based AMN Healthcare and Cross Country Healthcare out of Boca Raton, FL, both of which are publicly traded, for now. After shares in Cross Country ($1 billion revenues) fell two-thirds from its 2022 post-Covid highs, Cross Country agreed in May to a $400 million buyout. Based on a similar multiple, $3 billion (revenue) Jackson Healthcare is likely worth around $1 billion, according to Deutsche Bank analyst Pito Chickering.

While Jackson wouldn’t comment on the valuation or talk to Forbes, he’s done a handful of interviews and podcasts over the years that detailed some facts about his success and business, and also confirmed key facts over email.

His journey begins with his father abandoning the family when he was just 9 months old. His mother was an alcoholic with a 6th-grade education who worked as a cocktail waitress. Jackson grew up in Techwood Homes, a public housing project near the campus of Georgia Tech where he got his start selling newspapers, peanuts and scalping tickets to football games in his preteen years. It was a rough way to grow up and at age 13 he convinced an uncle to spend $66 of his welfare money to send him in a taxi to live in foster care, at the Methodist Children’s Home in Decatur. Jackson graduated from the Greater Atlanta Christian School, then couldn’t afford more than two quarters at Lipscomb University in Nashville, Tenn. He paid his way with early jobs at UPS, JCPenny and a collections agency. In 1974 he got his first job in staffing at a tiny firm called Perimeter Placement, where he helped find jobs for secretaries. After his boss quit, he convinced the owner to sell him the two-person shop (which meant Jackson took over the liabilities). A couple of years later he sold that business and got a job in 1977 with a small physician recruiter named Jackson C. Coker. “People get sick in good times and bad times,” he reasoned. After a year he bought that company too, under a 5-year payout, and renamed it Jackson & Coker. Hiring a Georgia State professor of business management at $2,000 a month to advise him, Jackson grew the company to be one of the nation’s largest physician search firms before splitting with the founder Coker in 1987 (Jackson kept the name).

ForbesLegendary Texas Wildcatter’s Granddaughter Makes Energy’s Riskiest Bet

Jackson then went on to start 10 new healthcare businesses including surgery centers, pain management, allergy clinics and staffing. He also bought a few. Not all worked. Allegiant Physician Services, which provided non-clinical services to hospitals and medical practices, went bankrupt in 1996; it took Jackson four years to make all the creditors whole. He decided then to never again take on outside investors, according to several interviews he’s given. In 2000 Jackson brought all the businesses – which then had just $20 million in combined revenue – together under Jackson Healthcare. According to a 2024 interview, Jackson was inspired by Warren Buffett to stop flipping companies; the number one thing I learned from him was the long-term hold.”

One of his newer acquisitions was a bankrupt, shuttered antibiotics plant in Bristol, Tennessee that he bought during Covid. It was a purposefully bad acquisition, done “not as a business investment but as a national security obligation,” Jackson has said. The 400,000 square-foot factory had supplied all of America’s Amoxicillin antibiotic prescriptions as recently as 2008. Then it gradually lost all of its market share, primarily to Indian generic drugmakers using Chinese chemicals. Jackson couldn’t believe that America had to depend on Chinese supply chains for 100% of a vital antibiotic. He restarted and renamed the plant USAntibiotics. It’s now designated by the Department of Homeland Security as a Critical Manufacturing Infrastructure Facility and supplies 8% of U.S. demand for Amoxicillin preparations like Augmentin. Jackson has reportedly sunk more than $50 million into it so far, with no profits yet.

Potential conflicts abound in his other businesses. Jackson Healthcare has lots of state health care staffing contracts, especially since COVID, when Gov. Brian Kemp called Jackson directly, asking for help maintaining a supply of doctors and nurses. Granted a no-bid contract, Jackson Healthcare has since received more than $1 billion in state payments according to his candidate financial disclosures. Jackson has said that if he’s elected Jackson Healthcare would not bid on new contracts and would work to “unwind” existing ones.

Despite Jackson’s strident stance in favor of enforcing immigration laws, he has taken hits on the campaign trail over hiring illegal immigrant landscapers at his Cumming estate. Plus his staffing companies have profited from importing thousands of medical workers, particularly under EB-3 visas. Several of them have sued Jackson’s subsidiary Avant Healthcare Professionals alleging that Avant violated labor laws and engaged in a racketeering conspiracy (RICO) by promising nurses “the American dream,” then locking them into predatory stay-or-pay contracts. A federal district court judge in Orlando ruled that the nurses can move forward as a class with their civil RICO complaint. The company denies the allegations.

Georgia has a history of rejecting moneyed candidates and outsiders, says UGA’s Bullock, most recently rejecting Kelly Loeffler (wife of billionaire Jeff Sprecher) who spent $34 million on her senate campaign in 2020 and lost. All Georgia governors have been political insiders, with one exception: Lester Maddux, elected in 1966 as a Democrat after rising to prominence as a segregationist who refused to serve Black customers at his Atlanta fried chicken restaurant the Pickrick, and chased off civil rights demonstrators with an axe handle.

Coming out of the private sector, Jackson wouldn’t have a reservoir of political capital to draw on. “If he gets elected governor he's going to get frustrated,” says Bullock. “As CEO he’s used to people saying, yes sir. He’ll find he has to do a little more stroking and hand holding.”

ForbesWhat’s Behind Tilman Fertitta’s $18 Billion Bet On Caesars EntertainmentBy Christopher HelmanForbesAcclaimed Physicist And His Daughter Are Burying Tiny Nuclear Reactors A Mile UndergroundBy Christopher HelmanForbesThe American LNG Billionaires Set To Cash In On War With IranBy Christopher Helman