{"id":7032,"date":"2025-07-21T09:00:00","date_gmt":"2025-07-21T09:00:00","guid":{"rendered":"https:\/\/medical-article.com\/?p=7032"},"modified":"2025-07-21T09:00:00","modified_gmt":"2025-07-21T09:00:00","slug":"georgia-shows-rough-road-ahead-for-states-as-medicaid-work-requirements-loom","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=7032","title":{"rendered":"Georgia Shows Rough Road Ahead for States as Medicaid Work Requirements Loom"},"content":{"rendered":"

Every time Ashton Alexander sees an ad for Georgia Pathways to Coverage<\/a>, it feels like a \u201ckick in the face.\u201d<\/p>\n

Alexander tried signing up for Pathways, the state\u2019s limited Medicaid expansion, multiple times and got denied each time, he said, even though he met the qualifying terms because he\u2019s a full-time student.<\/p>\n

Georgia is one of 10 states that haven\u2019t expanded Medicaid health coverage to a broader pool of low-income adults. Instead, it offers coverage to those who can prove they\u2019re working or completing 80 hours a month of other qualifying activities, like going to school or volunteering. And it is the only state currently doing so.<\/p>\n

\u201cWhy is this marketing out here?\u201d said the 20-year-old, who lives in Conyers, east of Atlanta. \u201cIt\u2019s truly not accessible.\u201d<\/p>\n

Each denial used the same boilerplate language, Alexander said, and his calls to caseworkers were not returned. State offices couldn\u2019t connect him with caseworkers assigned to him from the same state agency. And when he requested contact information for a supervisor to appeal his denial, he said, the number rang to a fax machine.<\/p>\n

\u201cIt\u2019s impenetrable,\u201d Alexander said. \u201cI\u2019ve literally tried everything, and there\u2019s no way.\u201d<\/p>\n

Millions of Americans trying to access Medicaid benefits could soon find themselves navigating similar byzantine state systems and work rules. Legislation signed into law<\/a> by President Donald Trump on July 4 allocates $200 million to help states that expanded Medicaid create systems by the end of next year to verify whether some enrollees are meeting the requirements.<\/p>\n

Conservative lawmakers have long argued that public benefits should go only to those actively working to get off of government assistance. But the nation\u2019s only Medicaid work requirement program shows they can be costly for states to run, frustrating for enrollees to navigate, and disruptive to other public benefit systems. Georgia\u2019s budget for marketing is nearly as much as it has spent on health benefits. Meanwhile, most enrollees under age 65 are already working<\/a> or have a barrier that prevents them from doing so.<\/p>\n

What Georgia shows is \u201cjust how costly setting up these administrative systems of red tape can be,\u201d said Joan Alker, executive director of Georgetown University\u2019s Center for Children and Families.<\/p>\n

Over the past two years, KFF Health News has documented the issues riddling Georgia\u2019s Pathways program, launched in July 2023. More than 100,000 Georgians have applied to the program through March. Just over 8,000 were enrolled at the end of June, though about 300,000 would be eligible<\/a> if the state fully expanded Medicaid under the terms of the Affordable Care Act.<\/p>\n

The program has cost more than $100 million, with only $26 million spent on health benefits and more than $20 million allocated to marketing contracts, according to a KFF Health News analysis of state reports.<\/p>\n

\u201cThat was truly a pretty shocking waste of taxpayer dollars,\u201d Alker said.<\/p>\n

The Government Accountability Office is investigating the costs<\/a> of the program after a group of Democratic senators \u2014 including both members of the Georgia delegation \u2014 asked the government watchdog to look into the program. Findings are expected this fall.<\/p>\n

A state report<\/a> to the federal government from March said Georgia couldn\u2019t effectively determine if applicants meet the qualifying activities criteria. The report also said the state hadn\u2019t suspended anyone for failing to work, a key philosophical pillar of the program. Meanwhile, as of March, more than 5,000 people were waiting to have their eligibility verified for Pathways.<\/p>\n

The Pathways program has strained<\/a> Georgia\u2019s eligibility system for other public benefits, such as food stamps and cash assistance.<\/p>\n

In April, the state applied to the federal government to renew Pathways. In its application, officials scaled back<\/a> key elements, such as the requirement that enrollees document work every month. Critics of the program also say the red tape doesn\u2019t help enrollees find jobs.<\/p>\n

\u201cGeorgia\u2019s experience shows that administrative complexity is the primary outcome, not job readiness,\u201d said Natalie Crawford, executive director of Georgia First, which advocates for fiscal responsibility and access to affordable health care.<\/p>\n

Despite the struggles, Garrison Douglas, a spokesperson for Georgia\u2019s Republican governor, Brian Kemp, defended the program. \u201cGeorgia Pathways is doing what it was designed to do: provide free healthcare coverage to low-income, able-bodied Georgians who are willing to engage in one of our many qualifying activities,\u201d he said in an emailed statement.<\/p>\n

New federal requirements in the tax and spending legislation mean that the 40 states (plus Washington, D.C.) that expanded Medicaid will need to prepare technology to process the documentation some Medicaid recipients will now have to regularly file.<\/p>\n

The federal law includes exemptions for people with disabilities, in addiction treatment, or caring for kids under 14, among others.<\/p>\n

The Trump administration said other states won\u2019t face a bumpy rollout like Georgia\u2019s.<\/p>\n

\u201cWe are fully confident that technology already exists that could enable all parties involved to implement work and community engagement requirements,\u201d said Mehmet Oz, head of the Centers for Medicare & Medicaid Services, in an emailed statement.<\/p>\n

In a written public comment on Georgia\u2019s application to extend the program, Yvonne Taylor of Austell detailed the difficulties she faced trying to enroll.<\/p>\n

She said she tried to sign up several times but that her application was not accepted. \u201cNot once, not twice, \u00a0but 3 times. With no response from customer service,\u201d she wrote in February. \u201cSo now I am without coverage.\u201d<\/p>\n

Victoria Helmly of Marietta wrote in a January comment that she and her family members take care of their dad, but the state law doesn\u2019t exempt caregivers of older adults.<\/p>\n

\u201cGeorgia should recognize their sacrifices by supporting them with health insurance,\u201d she wrote. \u201cLet\u2019s simplify this system and in the end, save money and lives.\u201d<\/p>\n

KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\n

USE OUR CONTENT<\/h3>\n

This story can be republished for free (details<\/a>).<\/p>","protected":false},"excerpt":{"rendered":"

Every time Ashton Alexander sees an ad for Georgia Pathways to Coverage, it feels like a \u201ckick in the face.\u201d Alexander tried signing up for Pathways, the state\u2019s limited Medicaid expansion, multiple times and got denied each time, he said, even though he met the qualifying terms because he\u2019s a full-time student. Georgia is one…<\/p>\n","protected":false},"author":0,"featured_media":7033,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-7032","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/7032"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=7032"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/7032\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/7033"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=7032"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=7032"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=7032"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}