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- Most Georgia Hospitals Don’t Comply With Federal Price Listing Rule Until Fined
- UnitedHealth Is Strategically Limiting Access to Critical Treatment for Kids With Autism
- Poor Health: Georgia’s High Rate of Early Births Earns State a Grade of F
- Poor Health: Georgia Named Worst State for Healthcare
- Poor Health: How is Georgia Addressing The State’s Mental Health Woes?
- Poor Health: Georgia Ranks 48th in The Nation in Health Quality
- Governor Kemp’s Plan for Better Health Coverage in Georgia
- Georgia Again Scrapes Bottom of The Barrel in Women’s Health
- How Will Lawmakers Respond to Georgia’s Health Care Crisis in 2025
Key Takeaways
- A federal review found that two-thirds of Georgia’s Medicaid funds went to administrative costs rather than medical assistance.
- The report revealed that more than half of the $80 million spent since 2021 was used for contractors overhauling eligibility systems.
- The Pathways to Coverage program requires applicants to prove 80 hours of work or community service monthly to maintain insurance.
- Enrollment numbers fell short, with only 7,500 insured by Pathways compared to the projected 25,000.
- Georgia plans to extend the program for another five years, estimating enrollment of over 30,000 by year five.
A federal review of Georgia’s unique implementation of Medicaid found that two-thirds of the money went to administrative overhead rather than to medical assistance.
The report from the U.S. Government Accountability Office also found that more than half of the $80 million spent on the program since 2021 went to contractors who helped the state overhaul its eligibility and enrollment system.
Georgia’s Pathways to Coverage demonstration project needed the overhaul because of the state’s work requirement. All applicants must prove they spent 80 hours working, attending college or doing community service during the month before applying.
They must continue those activities to stay insured.
A law passed by Congress this year makes other states impose similar work requirements.
The new GAO review was requested by four Democrats in the U.S. Senate, including Georgia Sens. Raphael Warnock and Jon Ossoff. They oppose the work requirements.
Warnock’s office released the report Thursday.
In a briefing with reporters, a Warnock staffer criticized the lower-than-advertised program enrollment. There were about 7,500 Georgians insured by Pathways in May, the review said, far below the 25,000 Georgia had projected for the first year.
“This program is here to kick people off their health insurance,” said the Warnock staffer, who asked not to be identified.
The Pathways program technically started in 2021, but it did not get off the ground until 2023.
That pause likely drove up administrative costs, said the review.
Georgia’s Republican governor, Brian Kemp, blames the administration of former President Joe Biden, a Democrat, for that pause. Kemp’s office said the Biden administration “put up roadblocks at every turn” to stop Pathways.
“Democrats like Senators Ossoff and Warnock are trying to rewrite history after four years of inaction and blame the State for costs associated with their own stonewalling,” Kemp’s office said in an emailed statement.
Georgia is applying to extend the program another five years. The state estimates it can enroll at least 18,000 in the first year of extension, increasing that to more than 30,000 by year five.
The federal government has budgeted $400 million for administrative costs to implement the same kind of work requirements in states across the country.
This story is available through a news partnership with Capitol Beat News Service, a project of the Georgia Press Educational Foundation.
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Before You Dismiss This Article…
We live in a time when information feels overwhelming, but here’s what hasn’t changed: facts exist whether they comfort us or not.
When A&W launched their third-pound burger to compete with McDonald’s Quarter Pounder in the 1980s, it failed spectacularly. Not because it tasted worse, but because customers thought 1/3 was smaller than 1/4. If basic math can trip us up, imagine how easily we can misread complex news.
The press isn’t against you when it reports something you don’t want to hear. Reporters are thermometers, not the fever itself. They’re telling you what verified sources are saying, not taking sides. Good reporting should challenge you — that’s literally the job.
Next time a story makes you angry, pause. Ask yourself: What evidence backs this up? Am I reacting with my brain or my gut? What would actually change my mind? And most importantly, am I assuming bias just because the story doesn’t match what I hoped to hear.
Smart readers choose verified information over their own comfort zone.
Ty Tagami | Capitol Beat
Ty Tagami is a staff writer for Capitol Beat News Service. He is a journalist with over 20 years experience.
