Georgia’s unique and often debated “Pathways to Coverage” Medicaid program has been granted a one-year extension by the federal government, ensuring its continuation through 2026. The program, which mandates recipients to demonstrate 80 hours of work, volunteering, or education per month, has faced challenges in enrollment but is now set to undergo significant modifications aimed at increasing accessibility and streamlining compliance.

The extension comes as the original program was slated to expire this month. The Center for Medicare & Medicaid Services (CMS) noted in its extension notice to the Georgia Department of Community Health that enrollment figures were considerably lower than initial projections. As of May, after 23 months of operation, only 7,463 individuals were enrolled, falling far short of the anticipated 47,000.

In response to these enrollment challenges and with the goal of expanding coverage, Governor Brian Kemp’s administration successfully requested permission to amend the program. Key among these changes is a shift from monthly reporting of qualifying activities to an annual reporting requirement. This adjustment is intended to “streamline” the compliance process for recipients.

Furthermore, two new categories have been introduced to broaden eligibility. Parents with children under the age of six will now be exempt from the work or activity requirement if their child is enrolled in Medicaid. Additionally, childless, able-bodied adults can satisfy the program’s mandates by participating in other state programs, including the Supplemental Nutrition Assistance Program (SNAP).

Governor Kemp’s office has hailed the extension as a validation of Georgia’s approach to Medicaid, emphasizing that such work or activity requirements will soon become a federal mandate across all states.

However, the program’s implementation has not been without scrutiny. A recent report by the U.S. Government Accountability Office (GAO) highlighted that a substantial two-thirds of the program’s implementation costs were allocated to administration rather than directly to medical assistance, with over half of the $80 million spent going to contractors.

Governor Kemp attributed increased costs to what he described as obstruction from the previous federal administration. He contrasted this with the current administration under President Donald Trump, stating, “Unlike the previous administration which chose to sue, obstruct, and delay, President Trump and his team have worked alongside us to improve Georgia Pathways and ultimately deliver a better program to Georgians who need it most.” Kemp expressed his anticipation of continuing this partnership.

The one-year extension allows Georgia to further refine its “Pathways to Coverage” program, with the new modifications aiming to address past enrollment shortfalls and make the unique Medicaid approach more accessible to eligible residents.