Medicaid Work Requirement Program in Georgia Wastes Twice as Much on Bureaucracy as Actual 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 nationwide, 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 directed towards administrative expenses rather than covering healthcare needs. The findings have sparked concerns about the effectiveness and efficiency of such programs. "This is a clear indication that the Pathways to Coverage program has failed to deliver on its promise," said Dr. Emily Chen, a health policy expert at the University of Georgia. "The excessive administrative costs are not only wasteful but also divert resources away from providing essential healthcare services to those who need them most." Georgia Governor Brian Kemp had previously touted the state's Pathways to Coverage program as a model for conservative legislatures across the country. However, critics have long argued that such programs prioritize bureaucratic overhead over actual health care outcomes. The GAO report highlights the need for policymakers to reassess their approach to Medicaid work requirements and focus on improving healthcare access and quality rather than imposing unnecessary administrative burdens. "The findings of this report should serve as a wake-up call for lawmakers to reevaluate the effectiveness of these programs," said Senator Karen Handel (R-GA), who has been critical of the Pathways to Coverage program. "We need to prioritize the needs of our constituents over bureaucratic red tape." The GAO report is part of an ongoing series, "Broken Pathways: How a Medicaid Work Requirement Program Fails Georgians," which aims to shed light on the challenges and inefficiencies associated with such programs. As the nation prepares for the implementation of federal Medicaid work requirements set to take effect in 2027, policymakers will need to carefully consider the lessons learned from Georgia's experience. The report serves as a stark reminder that administrative costs should not overshadow the core mission of providing quality healthcare services to those who need them most. Background and Context The Pathways to Coverage program was launched in 2019 as part of Georgia's efforts to expand Medicaid coverage under the Affordable Care Act (ACA). The program required able-bodied adults to work or participate in job training programs for at least 80 hours per month to maintain their Medicaid eligibility. Critics have argued that such requirements create unnecessary barriers to healthcare access and disproportionately affect low-income communities. Additional Perspectives Dr. Chen noted that the excessive administrative costs associated with the Pathways to Coverage program are not unique to Georgia. "Similar programs in other states have also faced similar challenges, highlighting the need for a more comprehensive approach to Medicaid reform," she said. Senator Handel emphasized the importance of prioritizing healthcare access and quality over bureaucratic overhead. "We must ensure that our policies are driven by the needs of our constituents rather than the interests of special interest groups," she said. Current Status and Next Developments The GAO report is expected to inform ongoing debates about Medicaid work requirements at the federal level. As policymakers consider the implications of this report, they will need to weigh the trade-offs between administrative costs and healthcare outcomes. In related news, a group of Democratic lawmakers has introduced legislation aimed at repealing federal Medicaid work requirements set to take effect in 2027. The bill, which has gained bipartisan support, would redirect resources towards improving healthcare access and quality rather than imposing unnecessary bureaucratic burdens. As the nation continues to grapple with the complexities of Medicaid reform, the findings of this report serve as a timely reminder of the need for policymakers to prioritize the needs of their constituents over administrative overhead. *Reporting by Propublica.*