Georgia's Medicaid Work Requirement Program Faces Enrollment and Retention Challenges

The Georgia Pathways to Coverage program, designed to provide health insurance to low-income adults through Medicaid work requirements, faces significant enrollment and retention challenges. Initially championed by Governor Brian Kemp as a model for reducing uninsured rates while controlling government spending, the program has enrolled only a small fraction of eligible residents. Enrollment and retention are complicated by administrative hurdles, including confusing paperwork and inconsistent communication from program administrators and insurance providers.

Luke Seaborn, a mechanic and one of the program's early enrollees, became the public face of Pathways through a promotional video but experienced multiple benefit cancellations due to bureaucratic issues such as new form requirements and missed notifications. The state's Division of Family and Children Services administers federal benefits programs but has been criticized for communication gaps and delays in addressing beneficiary concerns. The requirement for enrollees to document 80 hours of work, study, or volunteering monthly is only verified at enrollment and annual renewal, though monthly paperwork submission remains a source of confusion. Health insurance coverage reinstatements tend to follow intervention but do not resolve underlying systemic issues.

The Department acknowledges these challenges and is exploring ways to improve customer service and communication. Pathways represents a broader trend among Republican-led states implementing Medicaid work requirements, but the Georgia experience highlights the operational and compliance risks inherent in balancing work mandates with accessible healthcare coverage for low-income populations. These administrative difficulties may undermine the program's ability to reduce the uninsured rate effectively or control costs as intended, limiting its replicability as a policy model without significant reforms to streamline compliance and beneficiary support systems.