Federal watchdog report on Georgia’s Medicaid program raises concerns about administrative costs

Atlanta – A federal guard dog reported on Thursday that the Georgia program forcing valid adults to document unpaid work to obtain Medicaid spent much more in administrative costs than to provide health care.

The US Government Accountability Office report on Georgia Pathways comes after the Republicans forced similar work requirements to the United States as part of the “big and beautiful bill” signed by President Donald Trump.

From 2027, most adults looking for the coverage of Medicaid must first show that they work, take lessons or perform a community service for at least 80 hours per month. And they must be extremely poor, which earns income is not higher than the federal poverty line.

The report attributes most administrative costs to the implementation of changes in determining eligibility and registration of persons, as well as double technology, training and coordination while the State has argued to overcome the objections of the Biden administration.

“Now, the whole country can see what we already know about it – the reappearance program on the work of Medicaid of Georgia is the real waste, fraud and abuse,” said senator Raphael Warnock, one of the Democrats of Georgia who asked for the report. “This report shows that Pathways is incredibly effective in banning workers in health coverage and strengthens business consultants,” said its press release.

A spokesman for Republican Governor Brian Kemp replied that Democrats are responsible for additional spending.

“Now, while other states are preparing to adopt our model and to reject a large government’s health size, Democrats like the Senators Ossoff and Warnock are trying to rewrite history after four years of inaction and blame the state for the costs associated with their own Walling.”

Millions of eligible people will lose coverage due to the Trump law, because the administrative process will make them too difficult for them to document their work repeatedly, according to criticism, pointing towards what has happened in Georgia, which has so far been the only state that requires work requirements.

Georgia has among the highest rates of unwanted and is one of the 10 states that have refused to extend Medicaid to all adults with revenues of up to 138% of the level of federal poverty, as envisaged by the overhaul of the health care of President Barack Obama.

Instead, Kemp announced its launch in July 2023 by Georgia Pathways to Coverage, which limits Medicaid for adults to those who do not gain more than poverty wages, now set at $ 15,650 per year. The traditional Medicaid of Georgia always covers poor children, disabled adults, the poor in nursing homes and a handful of other adults.

At the national level, most adults on Medicaid in the states that have widened it already work, and in Georgia, around 246,365 adults are potentially eligible for health insurance or traditional ways. But a year after its launch, Pathways had registered around 4,300. From this spring, 6,514 adults were registered, according to the State Department of Community Health.

The Republicans defended the low registration, claiming that Medicaid should be temporary for people who can obtain insurance through an employer.

GAO analysis shows that from the year 2021 in the second quarter of 2025, Georgia declared $ 54.2 million in administrative expenses and $ 26.2 million in health care. The administrative part decreased more recently, by 96.5% during the year 2023 to 58.8% during the year 2024. It should drop more in 2025.

Almost 90% of these expenses were federal money and Georgia used $ 20 million in other federal subsidies to help implement the program, trying to facilitate people’s demand. Additional expenses are scheduled for improvements this year, advertising and staff training, notes the report.

“There are incredibly useless public spending on paperwork systems,” said Joan Alker, a health policy researcher at the Center for Children and Families from the University of Georgetown. “And spending money on business consultants to set up complex paperwork systems that people cannot navigate, which prevent them from health coverage, is one of the worst uses of taxpayers I can think of.”

Kemp announced that he now wanted to leave parents at low income with young children register without meeting the work requirements, as part of an extension of the tracks that required the approval of the Trump administration.

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Kramon is a member of the body for the Associated Press / Report for America Statehouse News Initiative. Report for America is a non-profit national services program that places journalists from local editorial rooms to account for undercurrent issues.