Georgia Pathways work requirement Medicaid expansion sees few enrollees in first quarter
Georgia officials say they’re working to spread awareness of Georgia Pathways to Coverage, the work-requirement Medicaid program the state launched earlier this year. (Jess Mador/WABE)
Georgia officials say they’re working to spread awareness of Georgia Pathways to Coverage, the work-requirement Medicaid program the state launched earlier this year.
So far, fewer than 1,400 people are participating.
Georgia Republican Gov. Brian Kemp has long touted Pathways as an effective way to cover more uninsured Georgians who don’t qualify for traditional Medicaid health insurance.
Pathways offers Medicaid coverage to low-income adults who successfully complete 80 hours per month of work, volunteering, education, job training or other approved activities.
When it launched in July, Georgia became the only state with such requirements for a limited Medicaid expansion program.
As of Oct. 13, 2023, the Georgia Department of Community Health reported there were a total number of 1,343 Pathways participants.
That is a far cry from the roughly 90,000 Georgians that Kemp’s office had anticipated earlier in the year would sign up during the program’s first two years.
The state “always expected a slow rollout,” said Garrison Douglas, a spokesman for Kemp, saying that as awareness of the coverage option grows, he expects the program’s enrollment numbers to tick up.
The Department of Community Health is still processing more than 12,000 applications, he said.
Still, healthcare advocates and General Assembly Democratic lawmakers continue to push for a full Medicaid expansion in Georgia under the federal Affordable Care Act.
“Georgia has already invested about $20 million in state funds to launch the Pathways to Coverage program and earmarked another $118 million for the current fiscal year. These low initial enrollment numbers do not match the investment made,” Georgia Budget and Policy Institute Director of Health Justice Leah Chan said in a statement from the group.
“Further data and more transparency are needed to help us gain a deeper understanding of program gaps and how the state can pivot to ensure taxpayer dollars are being utilized as intended — to connect uninsured Georgians with the healthcare they deserve.”
The Georgia Pathways program has been controversial since the beginning.
Kemp won approval for it under a federal waiver from the Trump administration in 2020.
The Biden administration blocked it a year later, with the United States Centers for Medicare and Medicaid Services arguing its work requirements would be impossible for many people to fulfill.
Georgia officials then sued. And in 2022, U.S. District Judge Lisa Godbey Wood allowed the work requirements to advance.
Full Medicaid expansion under the Affordable Care Act would cover another more than 400,000 uninsured Georgians and allow Georgia to take advantage of additional federal subsidies, in addition to a federal bonus.
“The federal government would have paid for at least 90% of the costs of insuring hundreds of thousands of Georgians under a full expansion. That compares with the expected 67% matching rate from the feds under the slimmer Kemp plan,” according to an analysis from KFF Health News.
Kemp has steadfastly opposed full Medicaid expansion, saying Pathways is a more “Georgia-centric” option for health coverage.
A proposal during the last General Assembly legislative session for full expansion failed to advance.
In September, state House Democrats again renewed their calls urging Kemp to consider Medicaid expansion.
The battle is likely to continue at the Capitol during the upcoming session, which begins in January.
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