A new Government Accountability Office (GAO) report commissioned by Senators Raphael Warnock (D) and Jon Ossoff (D) has unveiled how Governor Brian Kemp’s (R) Pathways to Coverage Medicaid work reporting requirement program failed to deliver results and work within budget.
The report shows that the Centers for Medicare & Medicaid Services (CMS) wrongly approved higher federal matching rates for certain administrative costs, wasting taxpayer dollars. The program was also found to be ineffective, enrolling only 3,500 individuals in the first year, far short of the state’s original goal of 25,028 enrollees.
For context, states have had the option to expand Medicaid under the Affordable Care Act (ACA). Before the ACA, Medicaid was largely limited to low-income children, pregnant women, parents of children, the elderly, and those with disabilities.
However, the ACA allowed states to expand Medicaid to adults with up to 133% of the federal poverty line. In place of this full expansion, Kemp created the Pathways to Coverage program.
It was created through a Section 1115 Medicaid Waiver and initially approved by the Trump Administration. The Biden Administration reversed this, but a federal judge allowed it to move forward. The program went live in July of 2023.
Furthermore, the report found that most of the administrative spending ($47.4 million or 88 percent) was financed by federal dollars. Typically, the federal government provides 50 percent of the funds for, but can pay up to 90 percent of certain administrative costs.
Warnock remarked on how the work reporting requirement program was the real example of waste, fraud, and abuse, as opposed to the claims made by President Donald Trump and DOGE about federal spending.
“This report shows that Pathways is incredibly effective at barring working people from health coverage and making corporate consultants richer,” he stated. “If Republican politicians were serious about getting people to work, they would have closed the coverage gap nationwide and cut out the government bureaucracy.”
“Instead, they have chosen to take health care away from millions of Americans who need it most to give a tax cut to the richest among us. It is wrong, it is immoral, and it only makes our country sicker and poorer,” Warnock concluded.
