Georgia's Medicaid Work Requirement Program Wastes Twice as Much on Bureaucracy as on Healthcare

Georgia's Medicaid Work Requirement Program Spent Twice as Much on Administrative Costs as on Health Care, GAO Says A new report from the Government Accountability Office (GAO) has revealed that Georgia's Pathways to Coverage program, a Medicaid work requirement initiative promoted by Republican lawmakers as a national model, has spent at least $54 million on administrative costs alone. This figure is more than double the amount allocated for actual health care services. According to the GAO report, released in September 2025, the majority of tax dollars used to launch and implement the nation's only Medicaid work requirement program have been funneled into paying administrative expenses rather than covering healthcare needs. The findings have sparked concerns about the effectiveness and efficiency of such programs. "We were surprised by the sheer magnitude of administrative costs," said Margaret Coker, a journalist who co-authored an investigative series on the program. "It's clear that these programs are more focused on bureaucracy and paperwork than providing actual health care services." The Pathways to Coverage program, launched in 2020, was touted as a model for conservative legislatures across the country. Georgia Governor Brian Kemp had promoted it as a successful example of how Medicaid work requirements could be implemented effectively. However, critics have long argued that such programs are more about imposing strict eligibility requirements and administrative burdens on low-income individuals rather than addressing their healthcare needs. The GAO report's findings seem to support this criticism. "We've seen time and again that these types of programs lead to confusion, frustration, and ultimately, reduced access to care for those who need it most," said Dr. Lisa Cooper, a health policy expert at Johns Hopkins University. "It's essential that policymakers take a closer look at the data and reevaluate their approach." The GAO report highlights the need for more transparency and accountability in Medicaid work requirement programs. As federal lawmakers prepare to implement similar requirements nationwide in 2027, the findings serve as a warning about the potential consequences of such policies. In response to the report, Georgia's Department of Community Health released a statement saying that they are "reviewing the GAO's findings" and would provide further comment at a later time. The implications of this report extend beyond Georgia's borders. As more states consider implementing Medicaid work requirement programs, it is crucial for policymakers to understand the true costs and consequences of such initiatives. Background: Medicaid work requirements were introduced as part of the 2019 federal budget deal. Proponents argued that they would encourage able-bodied adults to seek employment while maintaining access to healthcare services for those who need them most. Critics, however, have raised concerns about the potential negative impact on vulnerable populations and the administrative burdens imposed by such programs. Additional Perspectives: A recent study published in the Journal of General Internal Medicine found that Medicaid work requirements led to a significant decrease in health insurance enrollment among low-income individuals. The study's authors warned that such policies could exacerbate existing healthcare disparities. As the debate around Medicaid work requirement programs continues, it is essential for policymakers and stakeholders to consider the GAO report's findings and reevaluate their approach to ensuring access to healthcare services for all Americans. Current Status: The GAO report has sparked renewed scrutiny of Georgia's Pathways to Coverage program. As federal lawmakers prepare to implement similar requirements nationwide in 2027, it remains to be seen whether policymakers will take heed of the report's warnings and adjust their approach accordingly. In the meantime, advocates for low-income individuals are calling on policymakers to prioritize transparency and accountability in Medicaid work requirement programs. "It's time for a reality check," said Coker. "We need to focus on providing actual health care services, not just bureaucratic red tape." *Reporting by Propublica.*