ATLANTA, Ga. — Georgia wants Washington to pay 90 cents of every Pathways to Coverage dollar without the state adopting full Medicaid expansion under the Affordable Care Act, according to a Department of Community Health public notice and a federal bulletin.
Officials filed the amendment with the Centers for Medicare and Medicaid Services on Oct. 1. If approved, the higher match would begin Jan. 1, 2027. CMS is taking public comments from Oct. 9 through Nov. 8.
Pathways serves adults 19 to 64 with incomes at or below the federal poverty line, complete up to 80 hours of qualifying monthly activities and would not otherwise qualify for Medicaid. CMS green-lighted the demonstration in October 2020. Georgia asked for the enhanced match then and was turned down.
DCH’s fiscal table shows about $22.75 million in state funds and $204.75 million in federal funds for state fiscal year 2027 under a 90% match, climbing to about $120.57 million state and $1.085 billion federal in SFY 2028. The agency says new federal community-engagement rules will swell enrollment toward nearly 120,000 by mid-2028 and that Georgia’s ordinary match near 66.86% cannot sustain that load.
Georgians for a Healthy Future notes the filing changes financing, not who can enroll, and urges the state to keep covering low-income adults even if CMS says no. The group also wants enrollment and cost figures published for public review. The request stops short of converting Pathways into traditional expansion.
Hospital and clinic leaders across Georgia are watching the federal reply because Pathways is one of the few coverage lanes for working-age adults who fall short of standard Medicaid rules. A denial would force lawmakers to revisit the state share in the next budget cycle.