Georgia's Medicaid Work Requirement Program Wastes Half of Budget on Bureaucratic Red Tape

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 promoted by Governor Brian Kemp, 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 program's administrative expenses include salaries, benefits, and overhead costs for state employees managing the program. In contrast, only about $23 million was spent on health care services for eligible beneficiaries. "We're seeing a clear pattern of wasteful spending on bureaucratic red tape," said Margaret Coker, investigative reporter at The Current, who co-published the report with ProPublica's Local Reporting Network. "This is not what Georgians signed up for when they voted to expand Medicaid." The Pathways to Coverage program was introduced in 2020 as a model for other states to follow. Republican lawmakers have cited it as an example of how federal Medicaid work requirements can be implemented effectively. However, critics argue that the program's focus on administrative costs rather than actual health care services is a misallocation of resources. "This report highlights the need for greater transparency and accountability in state-run programs," said Dr. Emily Chen, a health policy expert at Emory University. "We must prioritize the needs of our most vulnerable citizens over bureaucratic overhead." The Centers for Medicare and Medicaid Services (CMS) extended the Georgia Pathways program through September 2026 on September 23, 2025. Background: Medicaid work requirements were introduced by the Trump administration in 2019 as a way to promote employment among low-income individuals. However, critics argue that these requirements can lead to increased administrative costs and reduced access to health care services for those who need them most. Implications: The GAO report raises concerns about the effectiveness of Medicaid work requirements and the potential for wasteful spending on administrative costs. As more states consider implementing similar programs, policymakers must carefully weigh the benefits against the costs and ensure that resources are allocated efficiently. Next Developments: The CMS extension of the Georgia Pathways program through 2026 is likely to be closely watched by lawmakers and health care advocates. The GAO report's findings may also inform future policy decisions regarding Medicaid work requirements nationwide. Sources: Government Accountability Office (GAO) Report, September 2025 The Current, "Broken Pathways: How a Medicaid Work Requirement Program Fails Georgians" Centers for Medicare and Medicaid Services (CMS), Press Release, September 23, 2025 *Reporting by Propublica.*