Georgia’s Medicaid Program Extended by One Year Amid Coverage Challenges

Georgia has received a one-year extension for its innovative Medicaid program, Pathways to Coverage, which was originally set to expire this month. The extension, granted by the federal government, allows the program to continue through 2026. The program requires participants to demonstrate that they are working, volunteering, or taking classes for at least 80 hours each month.

As of May 2025, only 7,463 individuals were enrolled in the program, a figure significantly lower than the initial projection of 47,000, as noted by the Center for Medicare & Medicaid Services in its extension notice to the Georgia Department of Community Health. To address these enrollment challenges, the state plans to implement modifications aimed at increasing participation.

Modifications to Increase Enrollment

The administration of Governor Brian Kemp has requested and received permission to amend the program’s compliance requirements. Instead of monthly reporting, participants will now report annually regarding their work and qualifying activities. Additionally, two new categories have been introduced to broaden eligibility: parents of children under the age of six will not be required to meet work or activity requirements if their child is enrolled in Medicaid. Furthermore, childless, able-bodied adults can fulfill requirements by participating in other assistance programs, including the Supplemental Nutrition Assistance Program.

Kemp’s office stated that the extension “further validates” Georgia’s approach to Medicaid, which will become a requirement in all states under a new federal law.

Financial Implications and Administration Costs

A recent report from the U.S. Government Accountability Office revealed that Georgia allocated approximately two-thirds of its implementation costs to administrative expenses rather than direct medical assistance. Of the total $80 million spent, more than half went to contractors, raising concerns about efficiency in program delivery.

Kemp criticized the previous administration under President Joe Biden, claiming that it contributed to increased costs by obstructing the program’s implementation. He praised former President Donald Trump for his administration’s support, stating, “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.”

As the state moves forward, officials are hopeful that the changes will lead to increased enrollment and improved healthcare coverage for Georgia’s low-income population. The ongoing adjustments reflect a commitment to providing essential services while navigating complex federal requirements and state-specific challenges.