Editor’s Note: This post has been updated to reflect the amended language in the House bill for states to verify Medicaid work requirements twice a year.
Georgia currently has the nation’s only Medicaid work requirement program — but draft legislation set to be debated in the House of Representatives on Tuesday could make that policy a law for tens of millions of other Americans.
The House Energy & Commerce Committee, on which U.S. Rep. Buddy Carter, a Republican from St. Simons, sits, wrote the bill to cut hundreds of billions of dollars in federally subsidized health care for impoverished people as part of the current federal budget process. At the same time, the Republican-led Congress wants to make permanent tax cuts favored by President Donald Trump that benefit wealthier Americans.
The House committee has decided that one of the ways to curb taxpayer spending is by establishing work requirements for some low-income adults who are enrolled in so-called Obamacare health insurance programs. Those policies include generous subsidies instituted under former President Joe Biden to make health insurance affordable, especially for low-income individuals and families who do not have insurance from their employers.
Republicans who back the draft bill believe that federal health care subsidies encourage waste and believe that work requirements will make low-income Americans more responsible. Critics, however, say point to data showing that more than 60% of Americans who have Medicaid-linked health care already work.
Health care advocates, meanwhile, say bureaucratic red tape for work requirement programs is so onerous that people end up losing coverage or dropping out of the program, even if they have a job. The subsequent loss of enrollees, therefore, is what saves government money, they say.
At least 13.7 million people would lose health insurance by 2034 as a result of the draft bill, which also curtails some Affordable Care Act coverage, according to analysis from the non-partisan Congressional Budget Office. In total, all the committee’s proposed changes — including those unrelated to heath care — would save the federal government at least $912 billion, the group said.
Rep. Carter said recently that he backs work requirements, as well as reducing the amount of money the federal government devotes to Medicare and Medicaid. “Am I suggesting we cut em? Absolutely not,” he said on Politically Georgia, the Atlanta Journal-Constitution’s political podcast. “I’m suggesting that we make them sustainable.”
The Current and ProPublica reported earlier this year that Georgia’s work requirement experiment, known as Georgia Pathways to Coverage, has cost taxpayers tens of millions of dollars while only enrolling around 3% of the nearly quarter of a million potentially eligible Georgians.
After difficulties verifying that the approximately 7,0000 people enrolled in Pathways meet requirements each month, the state has loosened its oversight. Georgia has asked the federal government to allow it to verify requirements once a year.
Congressional Republicans, however, appear to have ignored Georgia’s track record. The draft bill would require all states to enact work requirements for Americans between ages 18-64 who earn less than $23,400 annually in exchange for continued federally subsidized health coverage. The draft bill requires verification twice a year, although it leaves the exact mechanism up to individual states.
Since 2019, Georgia has paid Deloitte Consulting more than $51 million to design and manage Pathways, which launched in 2023.