The Georgia Medicaid program with work requirements has accepted just 1,343 residents in three months

ATLANTA (AP) — Georgia Gov. Brian Kemp's new health plan for low-income adults has enrolled just 1,343 people as of the end of September, about three months after its launch. The Atlanta Journal-Constitution Reports.

The Georgia Department of Community Health estimates that up to 100,000 people could ultimately benefit from Georgia Pathways to Coverage. But the nation's only Medicaid program that requires recipients to meet a work requirement is off to a very slow start.

“We will continue to work to educate Georgians about Pathways’ innovative and unique opportunity and recruit additional individuals in the coming months,” Kemp’s office said in a statement.

The slow progress of the program reflects fundamental deficiencies compared to Medicaid expansions in other states, including the added burden of submitting and verifying work hours, experts say. And some critics point out that this comes at a time when the state is removing tens of thousands of people from its Medicaid rolls — at least some of whom could be eligible for Pathways — as part of a federally mandated review.

“Pathways to Coverage falls far short of these commitments to uninsured Georgians. Expanding Medicaid would be a more effective way to provide meaningful care to citizens and connect them to care,” Laura Colbert, executive director of the advocacy group Georgians for a Healthy Future, said in a statement Friday.

The state Department of Health had refused to provide enrollment numbers to the newspaper until the Journal-Constitution notified Kemp's office that it would report that the state appeared to be violating its open records law. The ministry then made the documents available, but denied any violation of the law.

The Biden administration has already tried to revoke Georgia's Medicaid plan once and is monitoring it, so any missteps could have broader consequences. They could also hinder future Republican efforts make Medicaid eligibility contingent on work.

The State Pathways started on July 1st, just as it began a Medicaid Eligibility Verification following the end of the COVID-19 public health emergency. Federal law prohibited states from removing people from Medicaid during the three-year state of emergency.

The state had previously said it had delayed reassessment of 160,000 people who were no longer eligible for traditional Medicaid but could qualify for Pathways to help them maintain health insurance. But observers said they saw little outreach to specific populations.

Thirty-nine states have expanded Medicaid eligibility to almost all adults with incomes up to 138% of the federal poverty level, $20,120 per year for an individual and $41,400 for a family of four. North Carolina will become the 40th state to do so in December. None of these states require recipients to work to qualify.

This broader expansion of Medicaid was a key part of President Barack Obama's health care reform in 2010, but many Republican governors, including Kemp, rejected it. In addition to requiring employment, Pathways limits coverage to able-bodied adults earning up to 100% of the poverty level — $14,580 for an individual or $30,000 for a family of four.

Kemp has argued that a full expansion would cost too much money. State officials and Pathways supporters say the work requirement will also help convert Medicaid recipients to better private health insurance, arguing that working, studying or volunteering leads to better health.

Critics say many low-income people have difficulty logging the required 80 hours per month for work, volunteer work, study or vocational rehabilitation.