Special investigation: A look at Georgia’s Medicaid experiment
Georgia has one of the highest rates of uninsured people in America, a figure that includes many low-income neighbors in Coastal Georgia and across the state. Back in 2019, Gov. Brian Kemp and our state lawmakers passed a law designed to reverse that fact. Last fall, The Current and ProPublica started research to see if the resulting program, called Georgia Pathways to Coverage, was meeting its goals.
Standing before a cluster of television cameras on the steps of the state Capitol last month, Kemp called the program a success. He also suggested that this experiment in Medicaid reform could be a showcase for fellow conservatives seeking to overhaul safety net benefits.
Credit: Rahul Bali/WABE
Today, we published a story that reveals a more complex situation.
What the governor did not disclose was that his program is not achieving two primary goals: enrolling those people in health care and getting them to work, according to an examination by The Current and ProPublica. The findings were confirmed recently by an independent evaluation commissioned by the state that has yet to be publicly released, but that the governor and his health policy officials had at the time of that press conference.
Pathways is supposed to cover nearly a quarter-million low-income Georgians who can prove they are working, studying or volunteering. Enrollment figures are approximately 6,500.
What’s more: The Kemp administration has quietly rolled back a core tenet it heralded when it launched Pathways as an alternative to government entitlement programs for poor people that many conservatives deride as handouts and the nanny state. Rather than verifying that people are working every month, Georgia is confirming that participants meet these requirements only at the time of enrollment and upon their annual renewal, the state said in January. In the meantime, the state isn’t kicking anyone off the rolls.
Among the biggest findings in our story published as a member of ProPublica’s Local Reporting Network:
- Pathways has cost federal and state taxpayers more than $86.9 million, three-quarters of which has gone to consultants.
- A mere 6,500 participants have enrolled 18 months into the program, approximately 75% fewer than the state had estimated for Pathways’ first year.
- Thousands of others never finished applying, according to the state’s data, as reports of technical glitches mounted. The state also never hired enough people to help residents sign up or to verify that participants are actually working, as Georgia required, federal officials and state workers told The Current.
In response to Pathways’ low enrollment numbers, Kemp’s spokesperson Garrison Douglas said the governor never thought it was realistic to enroll the entire pool of eligible Georgians in the program. Douglas said Kemp’s health care strategy for low-income Georgians is superior to the alternative policy backed by Georgia Democrats and some Republicans — Medicaid expansion without work requirements. He said that’s because the strategy saves the state money and funnels participants into private health insurance instead of government plans that the Kemp administration has described as overregulated.
“As the governor has said repeatedly, those who continue to promote full Medicaid expansion are selling Georgians a bill of goods,” he said.
Georgia publicly touts its Medicaid experiment as a success. Numbers tell a different story.
By Margaret Coker
In January, Georgia Gov. Brian Kemp boasted that his experiment in Medicaid reform was a success, despite low enrollment numbers. Yet a report commissioned by the state and not yet publicly released suggested otherwise.
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