Georgia’s limited Medicaid expansion program, Georgia Pathways, has seen significantly low enrollment numbers due to a complex enrollment process and strict eligibility criteria. Only 4,231 individuals have enrolled, far below the projected 25,000. The program requires at least 80 hours per month of work or other qualifying activities, leading to numerous denials. Some enrollees faced unexpected consequences, such as losing coverage due to fluctuating income. Confusion and paperwork errors have also hindered enrollment. Suggestions to improve the program include simplifying eligibility, eliminating the activities requirement, and expanding coverage. The state’s efforts to raise awareness through a $10. 7 million ad campaign have yet to show significant results.