Nicholas Smith

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Emory Law Journal Online


Georgia’s Medicaid program is in flux. The State recently launched Pathways to Coverage, a partial Medicaid expansion program for non-disabled adults in households under 100% of the Federal Poverty Line, with eligibility contingent on reporting 80 hours of work per month. Pathways’ rollout coincides with Medicaid “unwinding,” an ongoing post-COVID redetermination process in which thousands of Georgians have already lost coverage. As such, Pathways could play an important role in offsetting the unwinding’s disenrollment effects. But Pathways may also serve as a test case for conservative lawmakers hoping to institute (or reinstitute) work requirements to restrict Medicaid coverage in their States.

Accordingly, understanding and improving the program’s implementation is an important task. To that end, this Paper will first provide background on the Medicaid program; discuss the Temporary Assistance for Needy Families program, the Supplemental Nutrition Assistance Program, and the Pathways program; and then survey some key issues with Pathways’ implementation, touching on enrollment and reporting, and highlighting lessons from TANF and SNAP along the way. It will conclude by returning to the personal and political stakes and briefly noting some recent legislative action on the topic.

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