(The Center Square) – The Centers for Medicare & Medicaid Services agreed to expand a program that provides health care coverage to Georgians who don’t qualify for traditional Medicaid, Gov. Brian Kemp said Thursday.
The Georgia Pathways to Coverage requires recipients to complete 80 hours a month of qualified activities that include work, education or community service.
CMS first approved the plan in 2019, but implementation was delayed until 2023 due to challenges from the Biden Administration, according to information from Kemp’s office. Thursday’s announcement means the program can operate through Dec. 30, 2026.
“We’re grateful to the Trump Administration and CMS for this approval, which supports our innovative, Georgia-centric approach to providing healthcare coverage to thousands of hardworking Georgians,” Kemp said. “Unlike the previous administration which chose to sue, obstruct, and delay, President Trump and his team have worked alongside us to improve Georgia Pathways and ultimately deliver a better program to Georgians who need it most.”
Three key changes were made. The expansion adds parenting a child younger than 6 as a qualifying activity. Those receiving coverage will only report qualifying activities and hours when they renew their coverage once a year. Coverage will now begin when the application is received by the state, instead of when it is approved.
The program has served 15,427 people since its launch, according to Kemp’s office.
A report from the U.S. Government Accountability Office released last week found that the state spent $54.2 million between Oct. 2020 and March 2025 on administrative costs and just $26.1 million on providing medical assistance. The state received $47.4 million from the federal government and spent $6.7 million of its own money to cover the administrative costs.
The state also overestimated how many people would sign up for the program, according to the report.
“In its demonstration application submitted to CMS in December 2019, Georgia estimated a full year equivalent enrollment of over 25,000 individuals in the first year of the demonstration,” the report said. “However, analysis of data reported by Georgia on enrolled member months by year indicated that actual full year equivalent enrollment was under 3,500 individuals during the first 15 months of enrollment.”
The report was commissioned by Georgia U.S. Sens. Raphael Warnock and Jon Ossoff, both Democrats.
“Now the entire country can see what we in Georgia already know – Georgia’s Medicaid work reporting requirement program is the real waste, fraud, and abuse,” Warnock said. “This report shows that Pathways is incredibly effective at barring working people from health coverage and making corporate consultants richer. If Republican politicians were serious about getting people to work, they would have closed the coverage gap nationwide and cut out the government bureaucracy.”
