Georgia’s Medicaid Work Requirement Program Spent Twice As Much On Administrative Costs As On Health Care, Gao Says

By Margaret Coker

The Current

This article was produced for ProPublica’s Local Reporting Network successful business with The Current.

Update, Sept. 24, 2025: This communicative has been updated to bespeak that connected Sept. 23, 2025, nan Centers for Medicare and Medicaid Services extended nan Georgia Pathways programme done 2026.

Most of nan taxation dollars utilized to motorboat and instrumentality nan nation’s only Medicaid activity request programme person gone toward paying administrative costs alternatively than covering wellness attraction for Georgians, according to a caller study by the Government Accountability Office, nan nonpartisan agency that monitors national programs and spending.

The authorities study examined administrative expenses for Georgia Pathways to Coverage, nan state’s research pinch activity requirements. It follows previous reporting by The Current and ProPublica showing that nan programme has costs national and authorities taxpayers much than $86.9 cardinal while enrolling a mini fraction of those eligible for free wellness care.

The GAO analysis, which does not see each the Pathways administrative expenses elaborate by nan news outlets, shows that arsenic of April nan Georgia programme had spent $54.2 cardinal connected administrative costs since 2021, compared to $26.1 cardinal spent connected wellness attraction costs. Nearly 90% of administrative expenditures came from nan national budget, nan study concluded, meaning that Georgia’s research is being funded by taxpayers astir nan country. Federal spending will apt summation fixed that nan Centers for Medicare and Medicaid Services has approved $6 cardinal much successful administrative costs not reflected successful this study because it was published earlier nan authorities submitted invoices.

The spending watchdog agency echoed its 2019 disapproval of nan Centers for Medicare and Medicaid Services for a lack of oversight of administrative costs associated pinch authorities initiatives approved successful nan sanction of Medicaid reform.

The September GAO study said nan Medicaid agency ne'er required Georgia to item nan costs of building and implementing nan program. The national support process for states that want to research pinch their Medicaid systems “does not return into relationship nan grade to which demonstrations will summation administrative costs,” nan study said.

Georgia Gov. Brian Kemp, a Republican, promoted Pathways arsenic an illustration of really chap conservatives astir nan state could overhaul national information nett benefits and extremity reliance connected what critics deride arsenic handouts to low-income Americans. Congressional Republicans cited Pathways arsenic a exemplary for nan federal Medicaid activity request law passed successful July that will return effect successful 2027. The Georgia Pathways programme was slated to expire Oct. 1, but the Trump management connected Tuesday approved an hold of nan research done Dec. 31, 2026.

The Georgia programme was expected to grow free wellness attraction to a group nan authorities had antecedently deemed ineligible for Medicaid: adults nether 65 years aged who gain little than nan national poorness statement of $15,650 a year. To qualify, Georgians had to beryllium that they work, study aliases unpaid astatine slightest 80 hours a month.

But enrollment successful Georgia Pathways has remained low. The astir caller authorities information shows that 9,175 of nan astir quarter-million low-income Georgians eligible for nan programme were enrolled arsenic of Aug. 31. Previous reporting by The Current and ProPublica revealed that was owed to glitches successful nan integer level group must usage to enroll, chronic understaffing successful nan authorities agency charged pinch enrollment thief and a maze of bureaucratic reddish tape.

Georgia officials antecedently told The Current and ProPublica that Pathways was ne'er designed to maximize enrollment. Carter Chapman, Kemp’s spokesperson, said Monday that nan Kemp management remains committed to Pathways and making refinements to meet nan wellness attraction needs of Georgians.

In December Democratic senators captious of Medicaid activity requirements, including Georgia’s Jon Ossoff and Raphael Warnock, had asked nan GAO to study connected nan administrative costs of implementing Pathways and verifying that recipients are working, studying aliases volunteering.

“Administrative spending has outpaced spending for aesculapian assistance (e.g., wellness attraction services)” for Georgia Pathways, nan study said. “This was apt driven by nan up-front administrative changes needed to instrumentality nan demonstration, nan delayed commencement day for enrollment, and immoderate plagiarism successful administrative spending owed to nan delay.”

Georgia officials told nan GAO that nan administrative costs associated pinch Pathways accrued by 20% to 30% because of a two-year hold caused by ineligible battles pinch nan Biden administration, which tried to extremity each Medicaid activity request programs that had been approved earlier nan Democratic president took agency successful 2021. State officials said nan hold resulted successful having to copy immoderate spending, including IT strategy changes, unit training and different implementation costs, nan study said. The study did not supply grounds to support nan state’s assertion.

“This study was requested by nan aforesaid individuals who person nary caller aliases bully ideas for addressing healthcare needs successful Georgia,” Chapman said successful a statement. “Now, arsenic different states hole to adopt our exemplary and cull one-size-fits-none large authorities healthcare, Democrats for illustration Senators Ossoff and Warnock are trying to rewrite history aft 4 years of inaction and blasted nan State for costs associated pinch their ain stonewalling.”

Warnock said nan GAO’s findings reenforce his guidance to nan Trump administration’s push to nationalize activity requirements because of nan magnitude of taxation dollars going to expenses different than wellness care.

“Now nan full state tin spot what we successful Georgia already know: Georgia’s Medicaid activity reporting request programme is nan existent waste, fraud, and abuse,” Warnock said successful a statement. “This study shows that Pathways is incredibly effective astatine barring moving group from wellness sum and making firm consultants richer.”

Ossoff called Georgia Pathways “a boondoggle that’s wasted tens of millions connected pricey consultants while Georgia hospitals struggle and Georgians get sick without wellness insurance.”

The GAO study does not see nan $27 cardinal that Deloitte Consulting earned to marketplace Pathways or nan astir $10 cardinal that went toward further consulting, including by different firms, and ineligible fees related to nan state’s two-year tribunal conflict pinch nan Biden administration.

Deloitte did not respond to a petition for comment. The patient antecedently declined to reply questions astir its Georgia Pathways work, referring requests for accusation to nan state’s Department of Community Health. The agency did not respond to requests for remark but antecedently described Deloitte’s trading and outreach activity arsenic “robust” and “comprehensive.”

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