Georgia has spent nearly $166 million on a Medicaid program designed to provide health insurance to low-income adults, but fewer than 21,000 residents were actively enrolled as of August 2026. Now, state officials are asking the federal government to cover a larger share of the program’s costs, raising questions about whether Georgia’s approach to expanding healthcare coverage is delivering enough benefits for the money spent.
The program, known as Georgia Pathways to Coverage, launched in July 2023 as an alternative to traditional Medicaid expansion under the Affordable Care Act. Unlike states that expanded Medicaid to nearly all qualifying low-income adults, Georgia established a system requiring participants to meet income limits and complete approved work, education, training or other qualifying activities. Supporters argue that the approach encourages employment and financial independence while providing health insurance, but critics say the requirements have created barriers that prevent thousands of eligible residents from obtaining coverage…