GAO Investigates Georgia’s Pathways to Coverage Program

News Summary

The U.S. Government Accountability Office has initiated an investigation into the financial impact of Georgia’s Pathways to Coverage program, the only active Medicaid work requirement initiative in the U.S. This inquiry comes as the state has faced criticism for its slow enrollment and rising administrative costs. With public opposition towards Medicaid cuts, the investigation’s findings are anticipated to be crucial for future legislative actions regarding Medicaid work requirements.

Atlanta – The U.S. Government Accountability Office (GAO) has launched an investigation into the costs associated with Georgia’s Pathways to Coverage program, the only active Medicaid work requirement initiative in the nation. This inquiry will assess the financial implications of the program, particularly as Republican lawmakers across the country consider implementing similar work requirements as a strategy to reduce an estimated $880 billion from the federal deficit over the next decade. The GAO’s findings are expected to be released in the fall of 2025.

Despite the ongoing investigation, a recent poll from KFF Health News indicates that the majority of the public opposes cuts to Medicaid funding. Critics of the Pathways program argue that Congress is advancing Medicaid work requirements too quickly without thoroughly understanding the potential consequences. In Georgia and Arkansas, previous attempts to enforce work requirements resulted in decreased Medicaid enrollment alongside rising administrative costs.

The Pathways to Coverage program, which launched on July 1, 2023, is a critical policy under Republican Governor Brian Kemp. This initiative is currently designed for individuals with incomes up to 100% of the federal poverty level, but Georgia has not expanded Medicaid to cover nearly all low-income adults. As of April 25, 2025, the program had enrolled only 7,410 individuals, significantly lower than anticipated based on previous estimates. The program has already incurred expenses exceeding $57 million, primarily for administration, and has resulted in delays for processing other benefit applications.

Context and Reactions

In light of these developments, a bipartisan group of Democratic Senators, including Jon Ossoff and Raphael Warnock from Georgia as well as Ron Wyden from Oregon, prompted the GAO investigation due to concerns over cost implications. Governor Kemp has proposed changes to the Pathways program, focusing on easing work requirements, especially for parents of young children. However, critics argue that the Pathways program is ineffective and has left thousands without coverage compared to a full Medicaid expansion.

The Centers for Medicare & Medicaid Services (CMS) has not provided public comment regarding its approval of Georgia’s work requirements. A 2019 GAO report highlighted that implementing such programs could be costly for states, often resulting in expenses running into hundreds of millions without a discernible increase in overall Medicaid spending. Support for work requirements has been voiced by officials from the Trump administration, even as concerns about the financial impact persist.

Public Sentiment and Legislative Action

In 2023, over 90% of U.S. adults eligible for Medicaid expansion were either gainfully employed or would qualify for exemptions from the work requirement, highlighting the potential disconnect between the implementation of these requirements and the actual needs of the population. During his confirmation hearing for the CMS, Mehmet Oz expressed his support for work requirements but recognized the importance of ensuring that they do not unfairly deny individuals access to Medicaid services.

As the GAO continues its investigation, the situation remains fluid, with Georgia’s Pathways program’s federal authorization set to expire in September 2025. Georgia’s plans to seek a renewal of this program will likely draw further scrutiny, especially in light of the financial analyses expected from the GAO’s comprehensive report.

Deeper Dive: News & Info About This Topic

• Bloomberg Law: Georgia Moves to Extend Medicaid Waiver with Work Requirement
• Wikipedia: Medicaid
• New York Times: Georgia Medicaid Work Requirement
• Google Search: Medicaid work requirements
• AP News: Medicaid Work Requirements in Georgia
• Encyclopedia Britannica: Health Care Coverage
• Modern Healthcare: Medicaid Work Requirements in Arkansas and Georgia
• Google News: Georgia Medicaid Program
• Georgia Recorder: Kemp Unveils Limited Medicaid Expansion Plan
• Google Scholar: Medicaid work requirements