Three Democratic senators requested the nation’s high nonpartisan authorities watchdog on Tuesday to research the prices of a Georgia program that requires some individuals to work to obtain Medicaid protection.
This system, referred to as “Georgia Pathways to Protection,” is the nation’s solely lively Medicaid work requirement.
Pathways has price tens of tens of millions in federal and state {dollars} on administration and consulting charges whereas enrolling 5,542 people as of Nov. 1, in response to KFF Health News’ reporting. The congressional letter cited the reporting in its request to the Authorities Accountability Workplace.
“Republicans are hell-bent on placing mountains of pink tape between People and their well being care,” Sen. Ron Wyden (D-Ore.), head of the Senate Finance Committee, stated in an announcement in regards to the letter he co-wrote. “Taxpayers deserve to listen to from an unbiased watchdog in regards to the true prices of the Republican well being care agenda.”
Georgia Sens. Jon Ossoff and Raphael Warnock co-signed the request.
The Democrats’ letter asks the GAO to arrange a abstract of the prices to run this system — and element how a lot of that has been picked up by the feds, break down the price of this system per particular person, and assess how Georgia has used contractors to run this system and the way federal officers have overseen it.
The request comes as President-elect Donald Trump, who supported work necessities in his first administration, is ready to take workplace and probably remodel how individuals qualify for Medicaid, the joint federal-state medical insurance program for people who find themselves disabled or have low incomes.
Many GOP-led states have pushed for work necessities in public advantages packages equivalent to Medicaid, arguing that they promote employment. Georgia’s Pathways program requires some Medicaid candidates to show they’re working, volunteering, or learning for 80 hours a month.
The primary Trump administration approved work requirements in 13 states. Solely Georgia’s program, which began on July 1, 2023, is in impact. A Medicaid work requirement launched in Arkansas was halted by a court docket order in 2019.
In November, South Dakota voters gave lawmakers a inexperienced mild to hunt a piece requirement for some Medicaid enrollees. In 2023, North Carolina lawmakers directed the state to seek work requirements if the federal authorities would approve such a waiver. And a few GOP-led states have indicated they could additionally search work necessities.
Georgia’s program has been a precedence of Republican Gov. Brian Kemp, and his staff defended this system.
“The Senators needs to be extra centered on analyzing the failures of the federal authorities to adequately present the companies they’re required to manage than searching for each alternative to criticize states which are taking progressive approaches,” Garrison Douglas, a Kemp spokesperson, stated in an emailed assertion.
Enrollment in this system, which as of Dec. 13 was 5,903, has fallen far in need of the state’s preliminary projection of greater than 25,000 within the first 12 months.
This system has price greater than $40 million in state and federal funds, largely administrative prices and never medical take care of enrollees, Georgia officers have stated. KFF Well being Information reported in March that Georgia officers estimated this system’s administrative prices might improve to $122 million over 4 years.
A spokesperson for Georgia’s Medicaid company, Fiona Roberts, stated the prices “elevated considerably” due to this system’s delayed launch. Whereas it was accredited by the Trump administration, the Biden administration tried to dam it, leading to a authorized battle.
KFF Well being Information has additionally reported that this system has slowed processing times for different Medicaid functions and for public advantages equivalent to money help and meals stamps.
In the meantime, greater than a 12 months after Pathways’ launch, Georgia officers stated they nonetheless had not eliminated enrollees for failing to show they’re working, volunteering, or learning for 80 hours a month, KFF Well being Information has reported.
“State leaders proceed to place taxpayer {dollars} behind their ineffective well being care program that has failed by almost each metric,” Warnock stated.
Earlier federal analysis means that the excessive prices per enrollee related to Georgia’s program could possibly be repeated elsewhere. The Trump administration didn’t correctly weigh administrative prices in state functions for work necessities, in response to a 2019 GAO report. Pathways is slated to run out on Sept. 30, except federal officers grant an extension.
KFF Health News is a nationwide newsroom that produces in-depth journalism about well being points and is likely one of the core working packages at KFF—an unbiased supply of well being coverage analysis, polling, and journalism. Be taught extra about KFF.
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