On Sept. 25, Georgia Gov. Brian Kemp shared how CMS extended the state’s Pathways to Coverage program through 2026, despite a recent finding from the U.S. Government Accountability Office that the Medicaid work requirement program had spent over twice as much on administrative expenses as on actual medical expenses over the program’s four-and-a-half-year lifespan.
From 2021 through the first half of 2025, Georgia spent $54.2 million on administrative costs, more than double the $26.1 million spent on medical assistance. About 88% of this administrative spending came from the federal government.
Medical costs only entered the equation after the program’s official launch in 2023, and state officials estimated administrative activities cost between 20% and 30% more due to a pause in implementation, leading to duplication.
This data comes after lawmakers requested the GAO to investigate the program.
As of April 2025, Georgia is the only state with active work requirements for Medicaid eligibility. Medicaid work requirements have recently gained interest among certain states, spurred by the promotion of such programs in the recently enacted budget bill. Under Georgia’s program, enrollees earning up to the poverty level typically need to complete 80 hours of work, job training, education or community service each month to be eligible for coverage.
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