ATLANTA — The U.S. Centers for Medicare and Medicaid Services approved Georgia’s request to extend the Pathways to Coverage program.
According to a release from the governor’s office, the program will continue through the end of 2026. If the extension had not been approved, the program would have ended on Sept. 30.
The program has a work requirement for beneficiaries to qualify for Medicaid coverage, including options to qualify such as job searching, being a student and working a job or volunteering.
“We’re grateful to the Trump administration and CMS for this approval, which supports our innovative, Georgia-centric approach to providing healthcare coverage to thousands of hardworking Georgians,” Gov. Brian Kemp said in a statement on Thursday.
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Under the current program, state officials said Georgia Pathways has served more than 15,000 beneficiaries.
Channel 2 Action News previously reported similar stats, shared by the governor’s in response to a recent oversight report of the program published by the U.S. Government Accountability Office.
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Before applying for the program’s extension in June, Georgia officials sued the federal government under the previous Biden administration to extend the time of the program, due to delays in approving its implementation.
At the time, the state lost the lawsuit and a federal judge recommended that they apply for an extension in the normal process through CMS, which happened in June, months after the lawsuit was dismissed.
According to Kemp’s office, the extension for Pathways to Coverage will include several key updates:
- Parents and legal guardians of children under six and enrolled in Medicaid will now be considered an additional qualifying activity, in addition to the previously approved qualifying activities of working, volunteering, and educational pursuits.
- Members will now only be required to report qualifying activities and hours at application and at annual renewal to continue their coverage. This will align with reporting requirements of other Medicaid programs in Georgia and reduce administrative burdens on both beneficiaries and the state.
- A retroactive coverage policy will be established for the Pathways to Coverage program, meaning coverage will now begin on the first day of the month in which an application is received.
The program has also seen some pushback by federal lawmakers from Georgia.
“Now the entire country can see what we in Georgia already know — Georgia’s Medicaid work reporting requirement program is the real waste, fraud, and abuse,” Sen. Rev. Raphael Warnock, a Georgia Democrat, said after the GAO report came out. “This report shows that Pathways is incredibly effective at barring working people from health coverage and making corporate consultants richer.”
The GAO report indicated high overhead costs compared to what the program spent on providing benefits, but a state spokesperson said the number of Georgians who had been able to get healthcare through Pathways and the state health insurance portal Georgia Access had risen to more than 817,000.
A spokesperson for the governor told Channel 2 Action News that more Georgians had received healthcare under the current system in the state than would have under a full Medicaid expansion, and for less cost.
Channel 2 Action News reached out to Warnock’s office for comment in response to the extension.
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