December 18,2024

Wyden, Ossoff, Warnock Seek Watchdog Investigation into Waste and Mismanagement in Georgia Pathways Program

“While hundreds of thousands of Georgians are left without the health coverage they need, taxpayer dollars are being funneled into the pockets of eligibility system vendors and consultants.”

Washington, D.C. – Senate Finance Committee Chair Ron Wyden, D-Ore., Senator Jon Ossoff, D-Ga., and Senator Raphael Warnock, D-Ga., urged the Government Accountability Office (GAO) to investigate the costs of implementing the Georgia Pathways to Coverage program, which the state has used to limit access to Medicaid coverage.

Only 4,231 Georgians have enrolled through this program as of June 2024, less than 1 percent of those who would be eligible had Georgia fully expanded Medicaid eligibility. Georgia Pathways has cost at least $40 million, with more than 80 percent of funds going towards administrative and consulting costs rather than health services for beneficiaries. While incredible sums of taxpayer dollars are being spent on the program, reports indicate that Pathways has been “mired in design flaws and system failures.”

In their letter to GAO Comptroller Gene L. Dodaro, the senators wrote, “Despite the high administrative cost of implementing and operating a work reporting requirement for Medicaid coverage, Georgia Pathways has enrolled less than one percent of the individuals who would be eligible to enroll had the state opted to fully expand its Medicaid program due to onerous barriers created by this policy. While hundreds of thousands of Georgians are left without the health coverage they need, taxpayer dollars are being routed into the pockets of eligibility system vendors and consultants.”

“Accordingly, we request that the Government Accountability Office (GAO) investigate both federal and state administrative burdens and costs associated with the Pathways section 1115 demonstration,” the senators continued, “This analysis is crucial to understand the impact administering Pathways has on federal and state spending, as well as the barriers to health care coverage Pathways has created either because of inherent design failure or mismanagement by state administrators.”

While Georgia is currently the only state authorized to condition access to Medicaid coverage on reporting working hours, understanding the full administrative costs of Pathways will prove illustrative going into the next Congress and presidential administration as more than eight states have laws that require them to pursue or consider pursuing these policies.

In March 2018, Wyden called on GAO to study the costs of implementing and administering harmful Medicaid work reporting requirements approved under the Trump administration. As a result, GAO released a 2019 investigative report, “Medicaid Demonstrations: Actions Needed to Address Weaknesses in Oversight of Costs to Administer Work Requirements,” which revealed the cost to administer work reporting requirements can range from millions to hundreds of millions per state, the vast majority of which is federal spending.

The full text of the letter can be found here.

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