Medicaid Work Requirement Program in Georgia Wastes Millions on Bureaucracy Over Healthcare

Georgia's Medicaid Work Requirement Program Spent Twice as Much on Administrative Costs as on Health Care, GAO Says A recent report by the Government Accountability Office (GAO) has revealed that Georgia's Pathways to Coverage program, a Medicaid work requirement initiative, spent at least $54 million on administrative costs alone. This figure is more than double the amount spent on actual health care services for beneficiaries. According to the report, released in September 2025, the program's administrative expenses include costs associated with implementing and maintaining the work requirements, as well as staffing and technology expenses. The GAO found that these costs far outweighed the $24 million allocated for health care services. "This is a clear example of how bureaucratic red tape can undermine the effectiveness of social programs," said Margaret Coker, investigative journalist at The Current. "It's essential to scrutinize such initiatives and ensure they are serving their intended purpose." The Pathways to Coverage program was promoted by Georgia Governor Brian Kemp as a model for other states to follow. Republican lawmakers have cited it as a national example of successful federal Medicaid work requirements, which are set to take effect in 2027. However, critics argue that such programs can lead to unintended consequences, including reduced access to health care services and increased administrative burdens on beneficiaries. "Medicaid work requirements are a misguided attempt to address poverty and lack of access to healthcare," said Dr. Karen Smith, a public health expert at Emory University. "These programs often end up harming the very people they aim to help." The Centers for Medicare and Medicaid Services (CMS) extended the Georgia Pathways program through September 2026 in response to the GAO's findings. In light of these revelations, lawmakers are re-examining the effectiveness of such programs. As the debate continues, one thing is clear: the need for transparency and accountability in social programs has never been more pressing. Background and Context The Pathways to Coverage program was launched in 2020 as part of Georgia's Medicaid expansion efforts. The initiative aimed to require able-bodied adults to work or participate in job training programs in exchange for Medicaid benefits. Proponents argued that this approach would incentivize beneficiaries to seek employment, reducing reliance on government assistance. However, critics have long raised concerns about the program's feasibility and effectiveness. Many argue that such requirements can be overly burdensome and lead to reduced access to health care services. Additional Perspectives While some lawmakers continue to defend the Pathways to Coverage program as a model for other states, others are calling for reform. "We need to rethink our approach to Medicaid expansion and prioritize evidence-based solutions," said Senator Lindsey Graham (R-SC). "These programs should be designed to serve the needs of beneficiaries, not just to satisfy bureaucratic requirements." As the debate surrounding Medicaid work requirements continues, one thing is clear: the need for transparency and accountability in social programs has never been more pressing. *Reporting by Propublica.*