Three Democratic senators requested the nation’s prime nonpartisan authorities watchdog on Tuesday to analyze the prices of a Georgia program that requires some individuals to work to obtain Medicaid protection.
This system, known as “Georgia Pathways to Protection,” is the nation’s solely lively Medicaid work requirement.
Pathways has price tens of thousands and thousands in federal and state {dollars} on administration and consulting charges whereas enrolling 5,542 individuals as of Nov. 1, in accordance with KFF Well being Information’ reporting. The congressional letter cited the reporting in its request to the Authorities Accountability Workplace.
“Republicans are hell-bent on placing mountains of purple tape between People and their well being care,” Sen. Ron Wyden (D-Ore.), head of the Senate Finance Committee, stated in an announcement in regards to the letter he co-wrote. “Taxpayers deserve to listen to from an impartial watchdog in regards to the true prices of the Republican well being care agenda.”
Georgia Sens. Jon Ossoff and Raphael Warnock co-signed the request.
The Democrats’ letter asks the GAO to organize a abstract of the prices to run this system — and element how a lot of that has been picked up by the feds, break down the price of this system per individual, and assess how Georgia has used contractors to run this system and the way federal officers have overseen it.
The request comes as President-elect Donald Trump, who supported work necessities in his first administration, is ready to take workplace and probably rework how individuals qualify for Medicaid, the joint federal-state medical insurance program for people who find themselves disabled or have low incomes.
Many GOP-led states have pushed for work necessities in public advantages applications reminiscent of Medicaid, arguing that they promote employment. Georgia’s Pathways program requires some Medicaid candidates to show they’re working, volunteering, or learning for 80 hours a month.
The primary Trump administration accredited work necessities in 13 states. Solely Georgia’s program, which began on July 1, 2023, is in impact. A Medicaid work requirement launched in Arkansas was halted by a court docket order in 2019.
In November, South Dakota voters gave lawmakers a inexperienced mild to hunt a piece requirement for some Medicaid enrollees. In 2023, North Carolina lawmakers directed the state to hunt work necessities if the federal authorities would approve such a waiver. And a few GOP-led states have indicated they could additionally search work necessities.
Georgia’s program has been a precedence of Republican Gov. Brian Kemp, and his workforce defended this system.
“The Senators must be extra centered on analyzing the failures of the federal authorities to adequately present the providers they’re required to manage than searching for each alternative to criticize states which can be taking progressive approaches,” Garrison Douglas, a Kemp spokesperson, stated in an emailed assertion.
Enrollment in this system, which as of Dec. 13 was 5,903, has fallen far wanting the state’s preliminary projection of greater than 25,000 within the first yr.
This system has price greater than $40 million in state and federal funds, largely administrative prices and never medical take care of enrollees, Georgia officers have stated. KFF Well being Information reported in March that Georgia officers estimated this system’s administrative prices may improve to $122 million over 4 years.
A spokesperson for Georgia’s Medicaid company, Fiona Roberts, stated the prices “elevated considerably” due to this system’s delayed launch. Whereas it was accredited by the Trump administration, the Biden administration tried to dam it, leading to a authorized battle.
KFF Well being Information has additionally reported that this system has slowed processing occasions for different Medicaid purposes and for public advantages reminiscent of money help and meals stamps.
In the meantime, greater than a yr after Pathways’ launch, Georgia officers stated they nonetheless had not eliminated enrollees for failing to show they’re working, volunteering, or learning for 80 hours a month, KFF Well being Information has reported.
“State leaders proceed to place taxpayer {dollars} behind their ineffective well being care program that has failed by practically each metric,” Warnock stated.
Earlier federal analysis means that the excessive prices per enrollee related to Georgia’s program could possibly be repeated elsewhere. The Trump administration didn’t correctly weigh administrative prices in state purposes for work necessities, in accordance with a 2019 GAO report. Pathways is slated to run out on Sept. 30, until federal officers grant an extension.
KFF Well being Information is a nationwide newsroom that produces in-depth journalism about well being points and is likely one of the core working applications at KFF—an impartial supply of well being coverage analysis, polling, and journalism. Be taught extra about KFF.
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