Georgia Governor Brian Kemp announced on Wednesday his intention to allow low-income parents with small children to enroll in a Medicaid program aimed at providing coverage for able-bodied adults without the need for employment. This announcement arrives as the Trump administration prepares to take office again, with various state and federal authorities re-evaluating the requirements associated with Medicaid enrollment.
Currently, Georgia is unique among the states for mandating that certain individuals work, study, or volunteer in order to qualify for Medicaid under the Georgia Pathways initiative. If Kemp’s plan gains approval from the incoming administration, parents or guardians of children aged six and younger, who are part of households earning at or below 100% of the federal poverty level, could gain access to Medicaid without having to meet these conditions.
Kemp emphasized the importance of health insurance for families, stating, “In a growing state that needs more Georgians in the workforce than ever before, providing health insurance to a family or individual with young children may be the last piece they need to restart a career and be on the path for a brighter future.”
In contrast to other states that extend Medicaid coverage to adults earning up to 138% of the federal poverty level primarily through federal funds, Kemp advocates for the Georgia Pathways program as an alternative to a full Medicaid expansion for low-income adults. Under the current program, participants are required to fulfill 80 hours of work, volunteering, or educational activities monthly to maintain their coverage. The aim, according to Kemp, is to facilitate a smoother transition into employment, which would allow individuals to secure jobs with private health insurance benefits.
However, the Georgia Pathways program has faced significant challenges since its inception. After its first year, only around 4,300 individuals were enrolled, which represents a minor fraction of the eligible population. Health policy analysts have criticized the program as a “failure,” arguing that the enrollment requirements are excessively challenging for many struggling residents.
Critics further assert that the program has been detrimental in terms of financial resources, with a report from KFF indicating that it has consumed over $40 million in public funds, primarily allocated to administrative expenses rather than medical care. Enrollment difficulties and prolonged processing times have also been major complaints from users of the program.
In response to the latest proposal, state Senate Democrats labeled it as “damage control” for the Georgia Pathways initiative. Democratic state Senator Jason Esteves from Atlanta remarked, “There are over half a million Georgians who need health insurance, and the governor’s proposal falls well short of that, and we’re leaving federal dollars on the table that would help close the coverage gap in Georgia,” adding, “Because of the governor’s plan, we will continue to struggle to strengthen our healthcare system.”
Despite the criticisms, Kemp maintains a firm stance on the Georgia Pathways program. “The old system is not working,” he declared. “And the other side, their only answer to any of this is they want government-run healthcare. And I am not in that boat.”
The Trump administration previously endorsed Medicaid work requirement proposals from 13 states but rescinded these waivers under the Biden administration in 2021. However, the Georgia Pathways program continued after a legal battle. For the program to proceed, Kemp must secure approval from the Trump administration, as it is due to expire in September. Kemp has indicated that discussions are ongoing, noting the incoming administration’s willingness to work collaboratively.
In contrast, he criticized the Biden administration for allegedly focusing on hindering Georgia’s healthcare efforts rather than supporting them. According to Kemp’s spokesperson, Garrison Douglas, the governor’s updated proposal will incur an additional cost of $207,000. To enhance participation, the state recently allocated $10.7 million to promote awareness concerning Georgia Pathways.
In a further development, Democratic senators, including Jon Ossoff and Raphael Warnock from Georgia, have advocated for a federal investigation into the Georgia Pathways program, signaling the ongoing scrutiny of its effectiveness.
