Every time Ashton Alexander sees an advertisement for Georgia's reporting, it feels like a “kick in the face”.
Alexander tried to register for paths, the limited Medicaid expansion of the state, and was denied every time, even though he met the qualification conditions because he is a full-time student.
Georgia is one of 10 countries that have not expanded Medicaid Hilk Insurance to a wider pool of adults with low incomes. Instead, it offers those who can prove that they work or complete 80 hours a month of other qualifying activities, e.g. B. to school or for volunteer work. And it is the only state that is currently doing this.
“Why is this marketing out here?” said the 20-year-old, who lives in Conyers east of Atlanta. “It is really not accessible.”
Each rejection used the same language of the boiler plate, said Alexander, and his calls for case workers were not returned. State offices could not combine him with the case workers assigned to him by the same state agency. And when he asked contact information for a manager to appeal against his rejection, the number was on a fax machine.
“It is impenetrable,” said Alexander. “I literally tried everything and there is no way.”
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Millions of Americans who try to access Medicaid could soon navigate similar Byzantine state systems and work rules. The legislation signed by President Donald Trump on July 4 on July 4 to help states that have expanded the creation of Medicaid systems by the end of next year to check whether some participants meet the requirements.
For a long time, conservative legislators have argued that public advantages should only go to those who are actively working on reducing state support. However, the only program for the nation's worker research shows that they can be expensive for states in order to navigate the participants frustrating and to disturb other public performance systems. The budget in Georgia for marketing is almost as strong as it spent on health benefits. In the meantime, most participants under the age of 65 have already worked or have a barrier that prevents them from.
What Georgia shows is “how costly the establishment of these administrative systems from bureaucracy can be,” said Joan Alker, Managing Director of the Georgetown University.
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In the past two years, KFF Health News has documented the topics launched in Georgia's Pathways program in July 2023. More than 100,000 Georgians have applied for the program by March. A little more than 8,000 were enrolled at the end of June, although around 300,000 are suitable if the state of Medicaid had completely expanded in accordance with the conditions of the Affordable Care Act.
The program cost more than 100 million US dollars, whereby, according to a KFF Health News Analysis, state reports were issued only 26 million US dollars for health benefits and more than 20 million US dollars for marketing contracts.
“It was really a rather shocking waste of tax money,” said Alker.
State accountability examines the costs of the program after a group of democratic senators – including the two members of the Georgia delegation – asked the state watchdog to deal with the program. The results are expected in autumn.
In a state report to the federal government in March it states that Georgia could not effectively determine whether the applicants meet the criteria for qualified activities. The report also said that the state had not exposed to anyone because of the work, an important philosophical pillar of the program. In the meantime, more than 5,000 people were waiting to verify their justification for paths.
The Pathways program has burdened Georgia's authorization system for other public services such as food brands and cash support.
In April, the state applied to the Federal Government's renewal. In his application, civil servants scaled back the most important elements, e.g. Critics of the program also say that bureaucracy does not help to find jobs.
“Experience in Georgia shows that administrative complexity is the primary result and not readiness for readiness,” said Natalie Crawford, Executive Director of Georgia First, which is committed to tax responsibility and access to affordable health care.
Despite the fights, Garrison Douglas, a spokesman for the Republican governor of Georgia, Brian Kemp, defended the program. “Georgia Pathways does what it has developed: provision of free health care for low-income Georgians who are willing to participate in one of our many qualifying activities,” he said in a statement given by email.
New federal requirements in tax and expenditure laws mean that the 40 states (plus Washington, DC), the Medicaid, have to prepare technology in order to process the documentation that some Medicaid recipients now have to submit regularly.
The federal law includes exceptions for people with disabilities, addiction treatment or for the care of children under the age of 14.
The Trump administration said other states will not be exposed to a bumpy rollout like Georgia.
“We are fully confident that technology already exists that could enable everyone involved to implement the requirements for work and commitment in the community,” said Mehmet OZ, head of the Centers for Medicare & Medicaid services, in an e -mail declaration.
In a written public comment on Georgia's application to expand the program, Yvonne Taylor von Austeell explained the difficulties with which she was confronted to enroll.
She said she tried several times to register, but that her application was not accepted. “Not once, not twice, but three times. Without an answer from customer service,” she wrote in February. “So I'm now without reporting.”
In a comment in January, Victoria Helmly from Marietta wrote that she and her family members take care of their father, but the state law does not freed the supervisors of older adults.
“Georgia should recognize their victims by supporting them with health insurance,” she wrote. “Let us simplify this system and finally save money and life.”
rrayasam@kff.org, @renurayasam
swhitehead@kff.org
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