Georgia's Medicaid program disproportionately allocates funds towards administrative expenses rather than direct patient care.
In the state of Georgia, the Medicaid work requirements program, Georgia Pathways, has been a subject of debate and scrutiny. The program, which limits eligibility to those earning no more than poverty-level wages, has been heavily funded by federal money, with nearly 90% of spending going towards it.
Georgia has utilised $20 million in other federal grants to help implement the program, with plans to spend more this year on improvements, publicity, and staff training. However, the search results do not provide information on how much money the company managing the Georgia Pathways program has spent on administrative costs.
The U.S. Government Accountability Office (GAO) has released a report on Georgia's Medicaid work requirement program, Georgia Pathways. The report states that Georgia Pathways has spent more on administrative costs than on providing health care. This has raised concerns among health policy researchers and politicians.
Sen. Raphael Warnock, a Georgia Democrat, stated that the report shows Pathways is effective at barring working people from health coverage and making corporate consultants richer. Joan Alker, a health policy researcher at Georgetown University's Center for Children and Families, criticized the spending on Georgia Pathways as wasteful and harmful to people's access to health care.
A spokesperson for Republican Gov. Brian Kemp countered that Democrats are responsible for the extra spending. The administrative portion of spending has declined from 96.5% in fiscal year 2023 to 58.8% in fiscal year 2024 and is expected to drop more in 2025.
The administrative costs are attributed to changes in determining eligibility, enrolling people, duplicative technology, training, and coordination. Critics argue that millions of eligible people will lose coverage due to the Trump law because the administrative process will make it too difficult for them to repeatedly document their work.
Starting in 2027, most adults who seek Medicaid coverage must first show they are working, taking classes, or performing community service for at least 80 hours a month and must be extremely poor, earning incomes no higher than the federal poverty line. As of this spring, there were approximately 6,514 adults enrolled in Georgia Pathways.
The state of Georgia has been litigating to overcome objections from the Biden administration. Governor Kemp announced plans to let low-income parents with young kids enroll without meeting work requirements, as part of an extension of Pathways that requires Trump administration approval.
The Trump law mandates similar work requirements throughout the U.S. as part of a "big, beautiful bill" signed into law. Georgia, along with 10 other states, refused to expand Medicaid to all adults with incomes of up to 138% of the federal poverty level. This means that traditional Georgia Medicaid still covers poorer children, disabled adults, people in nursing homes, and a handful of other adults.
The future of Georgia Pathways and similar programs remains uncertain, with ongoing debates and legal battles shaping the landscape of healthcare access for many Americans.
