Georgias Medicaid Work Requirement Experiment Sparks Concerns Over National Proposals

Georgia’s Medicaid work requirement experiment raises concerns for similar national proposals.

ATLANTA (AP) — Georgia’s trial of a Medicaid work requirement serves as a cautionary tale for a similar mandate proposed by Republicans in Congress. Despite nearing its two-year mark, the Georgia Medicaid program covers only about 7,500 low-income residents, significantly below the estimated 240,000 eligible individuals. Initially, the state projected at least 25,000 enrollees in the first year and nearly 50,000 in the second, but these numbers fell short.

Technical issues and difficulties in reaching support staff have plagued applicants and beneficiaries, despite over $50 million in federal and state funds spent on software and administration. The program, known as Georgia Pathways, had a backlog of over 16,000 applications 14 months after its launch in July 2023.

Laura Colbert, executive director of Georgians for a Healthy Future, notes the numerous obstacles in the program, making enrollment and retention challenging. Georgia’s work requirement mandates 80 hours a month of work, volunteer activity, schooling, or vocational rehabilitation, a unique feature among Medicaid programs.

Recently, Georgia halted monthly checks on whether beneficiaries met the requirement, which advocates see as evidence of overburdened state staff. Despite this, Governor Brian Kemp’s administration defends the program, attributing lower-than-expected enrollment to reduced uninsured residents due to job growth.

For some, like BeShea Terry, Pathways has been beneficial, allowing her to access necessary healthcare after being uninsured for over a year. However, she also faced issues, including erroneous messages about her work hours and a mistaken coverage cancellation that took months to resolve.

Health advocates argue that many low-income Americans lack the time or resources to meet such requirements, often struggling with basic needs and limited internet access. Most Medicaid recipients already work or are in school, caring for someone, or are sick or disabled.

Kemp’s administration promotes Pathways as a transition to private health care, with at least 1,000 people leaving the program for private insurance due to increased income. Advertising and outreach for Pathways have increased, but the program contrasts with Arkansas, where 18,000 people lost coverage under a similar mandate.

The House-passed bill, now in the Senate, could cause an estimated 5.2 million people to lose health coverage, according to the Congressional Budget Office. Arkansas is among several states pursuing work requirements for Medicaid, with new initiatives aiming to understand beneficiaries’ challenges and provide support before any suspensions.