ATLANTA, Ga. — Georgia Pathways to Coverage, the limited Medicaid program that ties health coverage to work, is scheduled to run out at the end of this year unless it is renewed, and its future will land on the desk of whoever wins Tuesday’s race for governor.
Gov. Brian Kemp launched Pathways in 2023 as an alternative to full Medicaid expansion under the Affordable Care Act, which 40 states and Washington, D.C., have adopted. It now covers more than 20,000 Georgians. To qualify, adults must earn no more than the federal poverty line, which this year works out to about $33,000 for a household of four, and log up to 80 hours a month of work, job training, community service or other approved activities.
The program helped shape the federal Medicaid work rules that take effect in most expansion states on Jan. 1. Those federal rules include exemptions that Georgia’s version does not, such as for people too sick to work, people with substance use disorders and caregivers for people with disabilities. State officials estimate that matching the federal rules would make about 100,000 more people eligible and add roughly $1.4 billion in spending by mid-2028.
The Department of Community Health, the state Medicaid agency, has asked the federal government for extra money to cover that group and has signaled it may let Pathways lapse without it. A spokesperson for Kemp said the governor backs the request. The federal Medicaid agency said it does not comment on pending requests. The state’s Pathways website already notes that eligibility rules will change on Jan. 1, 2027.
The candidates differ sharply. Democrat Keisha Lance Bottoms wants full Medicaid expansion and, according to her campaign, would overhaul Pathways to cut paperwork in the meantime. Republican Rick Jackson has proposed what he calls intelligent Medicaid expansion without offering many details. Full expansion would cover adults earning up to 138% of the poverty level, about $45,540 for a family of four, but a 2014 state law requires legislative approval, and Republican leaders have long opposed it.
Filed under: Atlanta GA Health News
