Georgia Medicaid Work Program Costs More, Yields No Gains

A Government Accountability Office review found Georgia’s Pathways to Coverage work‑requirement program spent about $54.2 million on administration versus $26.1 million on health care as of April, with nearly 90% of administrative costs covered by the federal government and the GAO faulting CMS for inadequate oversight. Independent research published in The BMJ found that 15 months after Pathways began, Medicaid coverage and employment did not increase in Georgia compared with neighboring states, and a secondary analysis showed a substantial relative decline in coverage versus South Dakota, which expanded Medicaid without work requirements. Earlier reporting calculated total state and federal spending on Pathways exceeded $86.9 million while enrolling only a small fraction of eligible people. Despite those findings, CMS approved an extension of Pathways from Oct. 1, 2025, through Dec. 31, 2026, and Governor Brian Kemp said planned changes will reduce administrative costs and expand coverage. Separately, HHS selected Ohio as one of five states to pilot a welfare‑to‑work program that emphasizes individualized, barrier‑focused supports.