The Republicans of the Congress who are looking for ways to compensate for their proposed tax cuts try to work millions of Americans to maintain state -subsidized health insurance. The GOP tax and budget bill said goodbye to the house in May, and the Republicans of the Senate are working feverishly to advance their draft of the federal spending cuts in the coming days.
Georgia, the only state with a medical work mandate, began to experiment with the requirements of the Medicaid program on July 1, 2023. As approaches to the two-year anniversary of the Medicaid program, Georgia has only enrolled a fraction of the legitimate researchers of the health guidelines, which has largely attributed bureaucratic hurdles in the state in the state-owned work medium. From May 2025, approximately 7,500 of the almost 250,000 eligible Georgians were enrolled, although state statistics show that 64% of this group work.
Governor Brian Kemp has long campaigned for Medicaid's reform and argues that the country should move away from state health care. His spokesman also informed the current and Prublica that the program, which is known as Georgia for reporting, was never designed in such a way that they maximize the registration.
Analysts of the healthcare system and former state medicaid officials say that experience in Georgia shows that the Congress Act, when it becomes a law, would cost taxpayers of millions of dollars of administrative costs, since they are implemented and at the same time threatened health care for almost 16 million people.
Here you will learn how the proposed work requirements of the federal government compared to Georgia – and how you can affect your state:
What the congress suggests:
In the proposal of the House Bill, the HR department and the Senate proposal, all states demands that the Americans aged 19 to 64 work by Medicaid -financed health insurance 80 hours a month, for a job, study or volunteer work. These new review systems should be present by December 31, 2026 and checked twice a year after the participants' work status. This means that people who already receive a cover, based on their level of income, have to be routinely demonstrated by their justification or lose their insurance.
The federal work requirements would apply to more than 10 million adults with low income with medicaid coverage and for around 5 million inhabitants of the 40 countries that have accepted federal subsidies for humans in order to make private health insurance through so-called Obamacare.
The house law frees parents of children under the age of 18 from the new requirements, while the Senate version frees parents with children under the age of 15.
Georgia's experience:
The Georgia's mandate applies to fewer categories of people than the proposed federal legislation. Nevertheless, the officials met the state's monthly monthly review needs of the state due to technical disorders and difficulties to confirm the employment of those who work in the informal economy such as domestic cleaners and landscapes, since they may not have any payment or tax documents. The challenges were steep enough that Georgia decided to loosen his working examination protocol from monthly to once a year.
What does this mean for your condition:
The Congress's budget office estimates that HR 1 would lead to at least 10 million Americans with low income losing health insurance. Proponents of the healthcare system say that this is not because they do not work, but because of the bureaucratic tires through which they would have to jump to prove employment. The research of KFF, a health policy for health policy, shows that the vast majority of the people who would already work to the new law are enrolled at school or unpaid nursing staff who restrict their ability to earn a salary elsewhere.
Arkansas is the only state as Georgia that has implemented work requirements. The Republican legislature of the state later changed her opinion after data had shown that bureaucracy lost more than 18,000 people in the first months of the directive. A federal judge hired the program in 2019 and decided that the non -insured interest rate of the state was increased without any signs of increased employment.
House's spokesman, Mike Johnson, a Republican in Louisiana, says that Medicaid's requirements in the HR department are “common sense”. He says that politics does not lead to loss of health insurance for the Americans who originally should help Medicaid, since the work requirements do not apply to these groups: children, pregnant women and older people who live in poverty. It refers to the 344 billion US dollars in a decade forecast cost savings that result from Medicaid work requirements that are advantageous for the country's fiscal health. “You would find at work, and the people who don't do that will try to attract your attention,” he said at the beginning of this year.
What the congress suggests:
The house bill condemns $ 100 million to support states in paying review systems that determine the authorization of a person. The grants would be distributed proportional to the proportion of Medicaid participants of the individual state. States, they say, will be the difference in the hook.
Georgia's experience:
In the two years since the start of his experiment with the work requirements, Georgia has spent almost 100 million US dollars for federal funds to implement paths. Of these, 55 million US dollars for the establishment of a digital system to check the authorization of the participants – more than half the amount in which Republicans were assigned to the republicans for the whole country to do the same.
As in other states, Georgia had already existed a working check system for food brand programs, but has joined Deloitte Consulting to meet the new Medicaid requirements. Georgian officials said that the state had spent 30% more than they were supposed to create its digital platform for paths due to the rising consultant and the IT costs. Deloitte previously refused to answer questions about the ways.
What does this mean for your condition:
All states already check the work requirements for recipients of the food stamps, but according to three former state medicaid officials, many existing systems would have to need upgrades to meet the proposed federal laws. When the states recently looked at the work requirements, a survey by the non -partisan accountability duty showed that Kentucky expected the administrative costs at 200 million US dollars – twice what the HR department assigned to the country.
MP Buddy Carter, the Republican who represents the coast of Georgia and the House of Health of the House Energy and Commerce Committee, who recommended Medicaid's cuts in HR 1, said that the pre -costs borne by states were compensated for by long -term savings that were promised in the house bill. Some Republicans of the Congress admit that the cost savings will come from Medicaid due to the new requirements. According to the Congress budget office, the savings from the working mandates amount to 43% of the proposed cuts of $ 793 billion.
What the congress suggests:
Medicaid is a program for the federal social security networks that is administered differently in each state. Neither HR 1 nor the Senate's proposal for the legislation offer a draft how states should check the authorization or how the costs for monitoring the new requirements are paid.
Georgia's experience:
Experience in Georgia shows that state case workers are the key to managing applications and checking the work requirements for the residents that come for Medicaid. The agency, which takes over the enrollment in federal benefits, had a vacancy rate of approximately 20%when Georgia initiated its working requirements policy in 2023. At that time Georgia had one of the longest waiting times for approval of the federal benefits. From March, the agency had a gap of more than 5,000 paths. The agency has announced that they need 300 other case clerk and IT upgrades to better manage the gap. This emerges from a report that was presented to the state legislator in June.
What does this mean for your condition:
Former state medicaid officials and experts in health policy say that the personnel fights in Georgia are not unique. In 2023, KFF interviewed at the end of the Covid-19 public health emergency about the level of personnel for case workers who check the justification for federal benefits, including medicaid. The vacancy rates of the employees exceeded 10% in 16 of the 26 countries that reacted; The interest rates exceeded 20%in seven of these countries.
Adding clerks means higher costs for states. At the moment, 41 countries require a balanced budget, which means that these state legislators must either increase taxes and income to check whether the Medicaid participants have to work or reduce costs in order to reduce costs, said Joan Alker, Managing Director of the Georgetown University.
In about half a dozen large states in which district governments manage the security network program of the states, the costs for the training of case workers in the new verification protocols could lawn from countries to counties.
“There are provisions that are very, very, very challenging, if not impossible, to implement for us,” said Senator Lisa Murkowski, a republican of Alaska, in June to the costs with which her state was confronted with the requirements for the budget bill.
This story was provided by Wabe Content Partner The Current, who produced it for the local report network from Prublica.
