Whenever Ashton Alexander sees an ad for the cover of Georgia Pathways, it looks like a “kick on the face”.
Alexander tried to register for Pathways, the limited expansion of state Medicaid, several times and was refused each time, he said, even if he has concluded the qualification conditions because he is a full-time student.
Georgia is one of the 10 states that have not widened Medicaid health coverage to a wider pool of low -income adults. Instead, it offers coverage to those who can prove that they work or finish 80 hours a month other qualification activities, such as going to school or volunteering. And it is the only state that does it today.
“Why is this marketing here?” said the 20 -year -old, who lives in Conyers, east of Atlanta. “It’s really not accessible.”
Each denial used the same Passe-Partout language, said Alexander, and his calls to social workers have not been returned. State offices could not connect it with social workers assigned to the same state agency. And when he asked for contact details for a supervisor to appeal his refusal, he said, the number has come to a fax.
“It’s impenetrable,” said Alexander. “I literally tried everything, and there is no way.”
Millions of Americans trying to access the benefits of Medicaid could soon find themselves navigating in similar Byzantine state systems and working rules. The legislation signed by President Donald Trump on July 4 allocates $ 200 million to help the states that have expanded Medicaid to create systems by the end of next year to verify whether some registrants meet the requirements.
Conservative legislators have long argued that public benefits should not go to those who actively work to leave government assistance. But the only Medicaid work obligation program in the country shows that they can be expensive for states, frustrating so that registrants can navigate and disrupt other public services systems. The georgia budget for marketing is almost as much as it has spent for health benefits. Meanwhile, most registered under 65 already work or have a barrier that prevents them from doing so.
What Georgia shows is “how much the costly implementation of these administrative systems can be,” said Joan Alker, executive director of the Center for Children and Families at the University of Georgetown.
Over the past two years, Kff Health News has documented the problems that have rid the Georgia pathway program, launched in July 2023. More than 100,000 Georgians applied to the program until March. Just over 8,000 were registered at the end of June, although around 300,000 would be eligible if the State was fully extended Medicaid under the terms of the affordable care law.
The program cost more than $ 100 million, with only $ 26 million spent on health benefits and more than $ 20 million allocated to marketing contracts, according to a KFF Health News analysis.
“It was really a fairly shocking waste of dollars of taxpayers,” said Alker.
The government of the Government of Government is investigating the costs of the program after a group of Democratic senators – including the two members of the Georgia delegation – asked the government’s watchdog to examine the program. The results are expected this fall.
A state report to the federal government from March said that Georgia could not effectively determine whether candidates meet the criteria for qualification activities. The report also indicates that the state had not suspended anyone for failing to work, a key philosophical pillar of the program. Meanwhile, in March, more than 5,000 people were waiting for their eligibility to check the tracks.
The Pathways program has set the georgia eligibility system for other public advantages, such as food coupons and cash assistance.
In April, the state asked the federal government to renew the tracks. In his candidacy, officials have reduced key elements, such as the requirement that registrants document work every month. Critics of the program also say that administrative formalities do not help registered jobs.
“Georgia’s experience shows that administrative complexity is the main result, not work preparation,” said Natalie Crawford, executive director of Georgia First, who defends tax responsibility and affordable health care.
Despite the difficulties, Garrison Douglas, spokesperson for the Republican Governor of Georgia, Brian Kemp, defended the program. “Georgia Pathways does what it was designed: offer free health coverage to low-income and valid Georgians who are ready to engage in one of our many qualification activities,” he said in a statement sent by email.
The new federal requirements in tax legislation and expenses mean that the 40 states (plus Washington, DC) which have expanded Medicaid will have to prepare the technology to process the documentation that certain beneficiaries of Medicaid must now deposit regularly.
Federal law includes exemptions for people with disabilities, treatment of drug addiction or the care of children under the age of 14, among others.
The Trump administration said other states will not face a bumpy deployment like that of Georgia.
“We are perfectly convinced that there is already a technology that could allow all the parties involved to implement requirements for commitment to work and to the community,” said Mehmet Oz, responsible for Centers for Medicare & Medicaid Services, in a press release sent by e-mail.
In a public comment written on the request for Georgia to extend the program, Yvonne Taylor d’Austell detailed the difficulties she encountered while trying to register.
She said that she had tried to register several times but that her request was not accepted. “Not once, not twice, but 3 times. Unanswered by customer service,” she wrote in February. “So now I’m without a cover.”
Victoria Helmly de Marietta wrote in a January commentary that she and her family members take care of their father, but the law of the State does not exercise the caregivers of the elderly.
“Georgia should recognize their sacrifices by supporting them with health insurance,” she wrote. “Simlify this system and ultimately, save money and lives.”
