Republicans have wanted to tie welfare benefits to work requirements for many years. One such proposal is to require some form of work in return for Medicaid benefits. Democrats opposed such measures, with the Obama and Biden Administrations blocking most applications. George is the only state so far with work requirements tied to Medicaid expansion under the Affordable Care Act.
Pathways is one of Republican Gov. Brian Kemp’s signature health policy initiatives and his alternative to fully expanding Medicaid eligibility under the Affordable Care Act. Applicants must document that they’re working, studying, or doing other qualifying activities for 80 hours a month in exchange for health coverage.
Critics argue that the program is boosting inefficiencies and slowing down enrollment in other welfare programs, like food stamps and Temporary Assistance for Needy Families. In Georgia employment verification for Medicaid eligibility and enrollment has been slow.
The percentage of Medicaid applicants waiting more than a month and a half to have their applications processed has nearly tripled in the first year of Pathways, the analysis of state and federal records found. Georgia had the slowest processing time in the country as of June, for income-based applications. Preliminary data from July puts the state as the second-slowest. The percentage of applications for financial and food assistance that take more than 30 days to process has also risen by at least 8 percentage points.Pathways “is really bogging down” a system that was “already functioning relatively poorly,” said Leah Chan, director of health justice at the Georgia Budget and Policy Institute, a nonprofit research organization that supports full Medicaid expansion.
The left-leaning Robert Wood Johnson Foundation estimates that under full Medicaid expansion nearly 300,000 Georgians would gain coverage. Yet, as of November 1st, only 5,542 had qualified under Georgia’s work requirement Pathways initiative. Policy analysts, most of which are left-leaning opponents of the program, warn that “If Georgia fails, that’s a big black eye for the Republican Party.” However, one has to wonder whether slow progress is a feature or a bug. Critics also claim the program is not cheap. Over a 3.5-year period from January 2021 administrative costs for each enrollee have been more than $13,000. By June 30, 2024 the Pathways program has cost Georgia just shy of $41 million when tallying both state and federal funds. Yet, it’s not clear what that means or what other potential costs may have been averted.
Georgia officials claim that much of the slowdown processing applications is due to the Medicaid unwinding after Covid. State Medicaid officials are not just determining applicants’ eligibility, they are also having to redetermine virtually all of the state’s Medicaid enrollee’s eligibility that was ramped up during Covid.
If the Georgia Pathways project fails that really says nothing about the merits of work requirements tied to welfare benefits. Other states will likely attempt similar programs and possibly succeed. States function as laboratories of reform, testing methods to see what works and what does not work. Under the Trump Administration, there will likely be many more work requirement pilot projects approved for various states to test.
Here in Minnesota, there is no work requirement — but things are just as backed up in the effort to redetermine eligibility after Covid. Confusing forms are mailed out to a demographic which may not read their mail, and outdated state computer systems plus no increase in staff leads to seemingly endless delays.
I have read that there are computer systems that can verify a person’s taxable income in seconds. Not sure why Medicaid needs a whole lot more than that.