Andy Miller and Renuka Rayasam and Sam Whitehead
Three Democratic senators requested the nation’s prime nonpartisan authorities watchdog on Tuesday to analyze the prices of a Georgia program that requires some folks to work to obtain Medicaid protection.
The program, referred to as “Georgia Pathways to Coverage,” is the nation’s solely lively Medicaid work requirement.
Pathways has value tens of tens of millions in federal and state {dollars} on administration and consulting charges whereas enrolling 5,542 people as of Nov. 1, in accordance with KFF Health News’ reporting. The congressional letter cited the reporting in its request to the Government Accountability Office.
“Republicans are hell-bent on putting mountains of red tape between Americans and their health care,” Sen. Ron Wyden (D-Ore.), head of the Senate Finance Committee, mentioned in a press release in regards to the letter he co-wrote. “Taxpayers deserve to hear from an independent watchdog about the true costs of the Republican health care agenda.”
Georgia Sens. Jon Ossoff and Raphael Warnock co-signed the request.
The Democrats’ letter asks the GAO to arrange 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 remodel how folks qualify for Medicaid, the joint federal-state medical health insurance program for people who find themselves disabled or have low incomes.
Many GOP-led states have pushed for work necessities in public advantages packages equivalent to Medicaid, arguing that they promote employment. Georgia’s Pathways program requires some Medicaid candidates to show they’re working, volunteering, or finding out for 80 hours a month.
The first Trump administration approved work requirements in 13 states. Only 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 gentle to hunt a piece requirement for some Medicaid enrollees. In 2023, North Carolina lawmakers directed the state to seek work requirements if the federal authorities would approve such a waiver. And some 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 group defended this system.
“The Senators should be more focused on examining the failures of the federal government to adequately provide the services they’re required to administer than looking for every opportunity to criticize states that are taking innovative approaches,” Garrison Douglas, a Kemp spokesperson, mentioned in an emailed assertion.
Enrollment in this system, which as of Dec. 13 was 5,903, has fallen far in need of the state’s preliminary projection of greater than 25,000 within the first 12 months.
The program has value greater than $40 million in state and federal funds, largely administrative prices and never medical look after enrollees, Georgia officers have mentioned. KFF Health News reported in March that Georgia officers estimated this system’s administrative prices may enhance to $122 million over 4 years.
A spokesperson for Georgia’s Medicaid company, Fiona Roberts, mentioned the prices “increased significantly” due to this system’s delayed launch. While it was accepted by the Trump administration, the Biden administration tried to dam it, leading to a authorized battle.
KFF Health News has additionally reported that this system has slowed processing times for different Medicaid functions and for public advantages equivalent to money help and meals stamps.
Meanwhile, greater than a 12 months after Pathways’ launch, Georgia officers mentioned they nonetheless had not eliminated enrollees for failing to show they’re working, volunteering, or finding out for 80 hours a month, KFF Health News has reported.
“State leaders continue to put taxpayer dollars behind their ineffective health care program that has failed by nearly every metric,” Warnock mentioned.
Previous federal analysis means that the excessive prices per enrollee related to Georgia’s program might be repeated elsewhere. The Trump administration didn’t correctly weigh administrative prices in state functions 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 Health News is a nationwide newsroom that produces in-depth journalism about well being points and is among the core working packages at KFF—an impartial supply of well being coverage analysis, polling, and journalism. Learn extra about KFF.
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