Lessons from Georgia’s 'Pathways' as new bureaucratic hurdles come for millions with Medicaid nationwide

This story was updated on Wednesday, July 16, 2025, at 2:59 p.m.

Now that Republicans’ big tax-and-spending bill has become law, there will be new bureaucratic hurdles for millions of Americans who rely on Medicaid for health coverage. The new law contains a provision that in most states, for the first time, low-income adults will have to start meeting work requirements to keep their coverage.

Some states have already tried this, but Georgia is the only state that currently has an active system using work requirements to establish Medicaid eligibility — and recipients must report to the system once a month.