U.S. Sens. Ron Wyden (D-OR), Jon Ossoff (D-GA), and Raphael Warnock (D-GA) are urging the Government Accountability Office (GAO) to investigate the costs of implementing the Georgia Pathways to Coverage program.
The senators say that the state has used this program to limit access to Medicaid coverage. As of June 2024, only 4,231 Georgians have enrolled through this program, which is less than 1 percent of those who would be eligible had Georgia fully expanded Medicaid eligibility.
Further, they say Georgia Pathways has cost at least $40 million, with more than 80 percent of funds going towards administrative and consulting costs rather than health services for beneficiaries.
“Despite the high administrative cost of implementing and operating a work reporting requirement for Medicaid coverage, Georgia Pathways has enrolled less than one percent of the individuals who would be eligible to enroll had the state opted to fully expand its Medicaid program due to onerous barriers created by this policy. While hundreds of thousands of Georgians are left without the health coverage they need, taxpayer dollars are being routed into the pockets of eligibility system vendors and consultants,” the senators wrote in a letter to GAO Comptroller Gene Dodaro.
The senators cite reports that indicate that the program has been hampered by design flaws and system failures.
“Accordingly, we request that the Government Accountability Office (GAO) investigate both federal and state administrative burdens and costs associated with the Pathways section 1115 demonstration,” the senators continued, “This analysis is crucial to understand the impact administering Pathways has on federal and state spending, as well as the barriers to health care coverage Pathways has created either because of inherent design failure or mismanagement by state administrators.”
The lawmakers said that understanding the full administrative costs of Pathways will prove illustrative going into the next Congress and presidential administration. That’s because more than eight states have laws that require them to pursue or consider pursuing these policies.