Georgia's Medicaid Work Requirement Program Spent Twice as Much on Administrative Costs as on Health Care, GAO Says

Source: ProPublica

Sept. 24, 2025, 6 a.m. EDT


Most of the tax dollars used to launch and implement the nation’s only Medicaid work requirement program have gone toward paying administrative costs rather than covering health care for Georgians, according to a new report by the Government Accountability Office, the nonpartisan agency that monitors federal programs and spending.

The government report examined administrative expenses for Georgia Pathways to Coverage, the state’s experiment with work requirements. It follows previous reporting by The Current and ProPublica showing that the program has cost federal and state taxpayers more than $86.9 million while enrolling a tiny fraction of those eligible for free health care.

The GAO analysis, which does not include all the Pathways administrative expenses detailed by the news outlets, shows that as of April the Georgia program had spent $54.2 million on administrative costs since 2021, compared to $26.1 million spent on health care costs. Nearly 90% of administrative expenditures came from the federal budget, the report concluded, meaning that Georgia’s experiment is being funded by taxpayers around the country. Federal spending will likely increase given that the Centers for Medicare and Medicaid Services has approved $6 million more in administrative costs not reflected in this report because it was published before the state submitted invoices.

The spending watchdog agency echoed its 2019 criticism of the Centers for Medicare and Medicaid Services for a lack of oversight of administrative costs associated with state initiatives approved in the name of Medicaid reform.

Read more: https://www.propublica.org/article/georgia-pathways-medicaid-work-requirement-gao-report