A federal watchdog reported Thursday that Georgia’s controversial program requiring able-bodied adults to document low-paying work to receive Medicaid benefits has incurred administrative costs far exceeding the amount spent on actual health care services. The U.S. Government Accountability Office (GAO) report on “Georgia Pathways” highlights the program’s financial inefficiencies, sparking debate as similar work requirements are slated for a national rollout.

The GAO’s findings reveal a stark imbalance in Georgia’s approach, where significant resources were dedicated to establishing and maintaining the system designed to verify work activities, rather than expanding direct health coverage. This comes as Republicans, under the Trump administration, mandated similar work requirements nationwide as part of a legislative package.

Beginning in 2027, most adults seeking Medicaid coverage across the U.S. will be required to show they are working, taking classes, or performing community service for at least 80 hours a month. These individuals must also meet stringent poverty guidelines, with incomes no higher than the federal poverty line, to qualify for coverage.

The report attributed the bulk of Georgia’s administrative outlays to a series of factors, including the complex implementation of changes in determining eligibility and enrolling people. Significant expenses were also tied to duplicative technology, extensive training, and coordination efforts, all compounded by the state’s litigation to overcome objections from the Biden administration regarding the program’s design.

The report drew sharp condemnation from critics of the program, particularly Georgia Democrats who have long argued against its efficacy.

“Now the entire country can see what we in Georgia already know — Georgia’s Medicaid work reporting requirement program is the real waste, fraud, and abuse,” said Sen. Raphael Warnock (D-GA), one of the lawmakers who requested the GAO report. “This report shows that Pathways is incredibly effective at barring working people from health coverage and making corporate consultants richer,” his statement concluded.

The findings from the GAO are expected to fuel further debate on the practicality and cost-effectiveness of work requirements within federal healthcare programs as the 2027 national rollout date approaches.