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GAO Finds Georgia’s Medicaid Work-Requirement Program Spent More on Overhead Than Care

The watchdog says spending centered on rebuilding eligibility systems tied to work reporting.

Overview

  • From FY2021 through Q2 FY2025, Georgia reported $54.2 million in administrative costs versus $26.2 million on medical care for the Pathways program, with nearly 90% of admin spending federally financed.
  • More than half of roughly $80 million spent since 2021 went to contractors to overhaul eligibility and enrollment systems after litigation prompted duplicative technology and training.
  • Enrollment has remained far below state projections, with about 7,500 people covered by May compared with the 25,000 forecast for the first year.
  • Georgia is seeking a five-year extension and projects at least 18,000 enrollees in the first year of the renewal, rising to more than 30,000 by year five.
  • A new federal law requires most adults to document 80 hours a month of work, education or service to qualify for Medicaid starting in 2027, with $400 million budgeted for state administrative implementation.