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Replace, Sept. 24, 2025: This story has been up to date to mirror that on Sept. 23, 2025, the Facilities for Medicare and Medicaid Providers prolonged the Georgia Pathways program by 2026.
Many of the tax {dollars} used to launch and implement the nation’s solely Medicaid work requirement program have gone towards paying administrative prices moderately than masking well being look after Georgians, in line with a brand new report by the Government Accountability Office, the nonpartisan company that screens federal packages and spending.
The federal government report examined administrative bills for Georgia Pathways to Protection, the state’s experiment with work necessities. It follows previous reporting by The Current and ProPublica displaying that this system has price federal and state taxpayers greater than $86.9 million whereas enrolling a tiny fraction of these eligible free of charge well being care.
The GAO evaluation, which doesn’t embody all of the Pathways administrative expenses detailed by the news outlets, reveals that as of April the Georgia program had spent $54.2 million on administrative prices since 2021, in comparison with $26.1 million spent on well being care prices. Practically 90% of administrative expenditures got here from the federal price range, the report concluded, which means that Georgia’s experiment is being funded by taxpayers across the nation. Federal spending will possible improve provided that the Facilities for Medicare and Medicaid Providers has authorised $6 million extra in administrative prices not mirrored on this report as a result of it was printed earlier than the state submitted invoices.
The spending watchdog company echoed its 2019 criticism of the Facilities for Medicare and Medicaid Providers for a lack of oversight of administrative prices related to state initiatives authorised within the title of Medicaid reform.
The September GAO report mentioned the Medicaid company by no means required Georgia to element the prices of constructing and implementing this system. The federal approval course of for states that need to experiment with their Medicaid techniques “doesn’t consider the extent to which demonstrations will improve administrative prices,” the report mentioned.
Georgia Gov. Brian Kemp, a Republican, promoted Pathways for instance of how fellow conservatives across the nation may overhaul federal security web advantages and finish reliance on what critics deride as handouts to low-income People. Congressional Republicans cited Pathways as a mannequin for the federal Medicaid work requirement law handed in July that may take impact in 2027. The Georgia Pathways program was slated to run out Oct. 1, however the Trump administration on Tuesday authorised an extension of the experiment by Dec. 31, 2026.
The Georgia program was presupposed to develop free well being care to a bunch the state had beforehand deemed ineligible for Medicaid: adults beneath 65 years previous who earn lower than the federal poverty line of $15,650 a yr. To qualify, Georgians needed to show that they work, research or volunteer a minimum of 80 hours a month.
However enrollment in Georgia Pathways has remained low. The newest state knowledge reveals that 9,175 of the almost quarter-million low-income Georgians eligible for this system had been enrolled as of Aug. 31. Earlier reporting by The Present and ProPublica revealed that was on account of glitches within the digital platform individuals should use to enroll, power understaffing within the state company charged with enrollment assist and a maze of bureaucratic red tape.
Georgia officers beforehand instructed The Present and ProPublica that Pathways was never designed to maximize enrollment. Carter Chapman, Kemp’s spokesperson, mentioned Monday that the Kemp administration stays dedicated to Pathways and making refinements to satisfy the well being care wants of Georgians.
In December Democratic senators crucial of Medicaid work necessities, together with Georgia’s Jon Ossoff and Raphael Warnock, had requested the GAO to report on the executive prices of implementing Pathways and verifying that recipients are working, learning or volunteering.
“Administrative spending has outpaced spending for medical help (e.g., well being care providers)” for Georgia Pathways, the report mentioned. “This was possible pushed by the up-front administrative modifications wanted to implement the demonstration, the delayed begin date for enrollment, and any duplication in administrative spending because of the delay.”
Georgia officers instructed the GAO that the executive prices related to Pathways elevated by 20% to 30% due to a two-year delay brought on by authorized battles with the Biden administration, which tried to finish all Medicaid work requirement packages that had been authorised earlier than the Democratic president took workplace in 2021. State officers mentioned the delay resulted in having to duplicate some spending, together with IT system modifications, employees coaching and different implementation prices, the report mentioned. The report didn’t present proof to assist the state’s assertion.
“This report was requested by the identical people who haven’t any new or good concepts for addressing healthcare wants in Georgia,” Chapman mentioned in a press release. “Now, as different states put together to undertake our mannequin and reject one-size-fits-none massive authorities healthcare, Democrats like Senators Ossoff and Warnock try to rewrite historical past after 4 years of inaction and blame the State for prices related to their very own stonewalling.”
Warnock mentioned the GAO’s findings reinforce his opposition to the Trump administration’s push to nationalize work necessities due to the quantity of tax {dollars} going to bills aside from well being care.
“Now the complete nation can see what we in Georgia already know: Georgia’s Medicaid work reporting requirement program is the true waste, fraud, and abuse,” Warnock mentioned in a press release. “This report reveals that Pathways is extremely efficient at barring working individuals from well being protection and making company consultants richer.”
Ossoff referred to as Georgia Pathways “a boondoggle that’s wasted tens of thousands and thousands on dear consultants whereas Georgia hospitals wrestle and Georgians get sick with out medical insurance.”
The GAO report doesn’t embody the $27 million that Deloitte Consulting earned to market Pathways or the roughly $10 million that went towards further consulting, together with by different companies, and authorized charges associated to the state’s two-year courtroom battle with the Biden administration.
Deloitte didn’t reply to a request for remark. The agency beforehand declined to reply questions on its Georgia Pathways work, referring requests for data to the state’s Division of Group Well being. The company didn’t reply to requests for remark however beforehand described Deloitte’s advertising and outreach work as “strong” and “complete.”
