The Center for Medicare & Medicaid Services (CMS) has approved an extension for the Georgia Pathways to Coverage program, Republican Gov. Brian Kemp, who worked alongside the Georgia Department of Community Health (DCH), announced Thursday.
The Georgia Pathways to Coverage program is a Medicaid program for able-bodied adults who otherwise would not qualify for Medicaid, and it includes a work requirement that has faced praise from conservatives — even heralded as a national model for work requirement Medicaid programs — but criticism from others.
Supporters claim the program lowers the uninsured rate, and helps program participants achieve financial independence. It has served 15,427 beneficiaries since it was launched in 2019, according to Kemp’s office.
The program was set to expire Oct. 1 without the extension approval.
Kemp responded to criticism over the program, including high administrative costs a ProPublica investigation found exceeded funds spent on health care costs for members.
He said the program had faced several delays due to legal challenges from the Biden administration before implementation was approved in 2023, resulting in higher upfront costs.
“Unlike the previous administration, which chose to sue, obstruct, and delay, President Trump and his team have worked alongside us to improve Georgia Pathways and ultimately deliver a better program to Georgians who need it most,” Kemp said in a press release. “We look forward to continuing that partnership in the months ahead.”
Kemp added that because of related policies mandated in President Donald Trump’s “One Big Beautiful Bill” (H.R.1), other states are now looking to the Peach State as a model.
Beginning October 1, 2025, and continuing through to December 31, 2026, the extension includes updates designed to expand access and improve experience for eligible low-income residents.
Work requirements can be waived based on volunteerism, educational pursuit or for parents and legal guardians of children under six years old who are enrolled in Medicaid.
To reduce administrative burdens, members are now required to report qualifying activities and hours only when they apply and during their annual renewal process to continue coverage.
The Pathways to Coverage program will also include a retroactive coverage policy, which allows coverage to begin on the first day of the month that an application has been submitted.
