Georgia Republican leadership continues blowing smoke about medicaid “Pathways” success

While I’ve been off the journalistic grid for months, I’m coming off the bench to address recurring Republican leadership failures in Georgia’s state legislature.

I’ll focus on a Sept. 24 Elberton Star article by Ty Tagami of the Capitol Beat News Service, headline “Trump administration gives one-year extension to Georgia’s health insurance program (Pathways) for the poor.”

This will be a two-part column given the complexity of healthcare coverage in Georgia/ the U.S and the need to discuss the failures of Georgia’s Republican leadership to improve healthcare coverage and the concurrent waste of state taxpayer funds to mitigate Georgia’s healthcare shortfalls.

I’ve written previously about Georgia’s lame attempt to increase Medicaid healthcare coverage. Georgia’s bright Einstein idea to provide health insurance coverage to poor/marginalized Georgia adults between the ages of 19 to 64, is called “Pathways to Coverage.”

Since July of 2023, low-income adults can qualify for Medicaid by meeting specific work/ school/ community engagement requirements. The enrollment results have been nothing short of abysmal!

lll share facts to put everything in perspective. Healthcare coverage for poor, hardworking, and struggling folks is why our federal government is currently shut down.

Approximately 1.2 million Georgians under age 65 don’t have health insurance, including 171,000 children (2023 U.S. Census). That’s 11 percent of Georgia’s population. Georgia’s tied for No. 2 with Oklahoma in uninsured population ranking. A dubious statistic. Pathetic. Texas is No. 1.

Georgia also has 200,000 working adults who fall into what’s called the ‘‘healthcare coverage gap.” These are folks making too much to qualify for Medicaid (income less than the $15,000 Federal Poverty Level) but don’t make more than 138 percent of the Federal Poverty Level (around $21,000) to qualify for Affordable Care Act insurance premium subsidies, which reduce insurance costs for high quality, commercial insurance plans.

The state Republican majority legislature in Atlanta has been steadfast in refusing federal Medicaid Expansion benefits, which would provide healthcare coverage to those 200,000 hardworking Georgians in the coverage gap and cover 90 percent of the costs!

A total of 40 other states expanded Medicaid coverage, recognizing the greatly improved quality of life and increased work productivity the expanded coverage provides to those in the “coverage gap.”

Over 20 million hardworking Americans in these 40 states have also benefitted from Medicaid Expansion. Georgia’s Republican legislature has basically rigidly extended one of its 5 fingers to 200,000 folks, for years. A very hypocritical stance for a Republican state that flaunts its staunch Christian beliefs as a benchmark for governance. God always has the backs of the poor, sick and downtrodden. He expects all levels of government/ leadership to take care of those marginalized folks. Has Georgia’s Republican government censured (redacted) those parts of the Bible that reflect those mandates?

Fast-forward to the poorly thought-out Georgia Republican “Pathways to Coverage” healthcare plan. Its first resounding failure is that it does ABSOLUTELY NOTHING to address providing healthcare coverage to 200,000 blue collar, hard-work- ing folks in the healthcare coverage gap mentioned above. The Pathways program ONLY applies to those at or below the Federal Poverty Level (FPL). What the heck guys? Georgia lamely/falsely calls the Pathways ‘‘Medicaid Expansion” a success, but nothing could be further from the truth. It only makes those who are eligible qualify for basic/traditional Medicaid coverage. Before the Pathways program kicked off, Georgia estimated 240,000 folks could potentially qualify for Pathways basic Medicaid.

I won’t quote the often, drastic downwardly revised enrollment goals Georgia had for Pathways, but after the first year, only 4,251 folks were enrolled (1.8 percent of those potentially eligible).

As of May 2025, almost two years later, only 7,463 folks had been enrolled (3.1 percent of eligible folks).

For Elbert, with a 13 percent uninsured rate, a measly NINE folks are enrolled in Pathways. Guys and gals, on a basic grade scale of 0-100, where below 60% is an “E,” Georgia’s Pathways to Coverage healthcare expansion program is below a double F-minus! You can’t find the words in Webster’s Dictionary to define HOW BAD this program has been, and yet Governor Kemp is crowing from the steps of the Atlanta Capitol that our federal government has extended this pitiful excuse for healthcare coverage expansion in Georgia.

The work/school hour requirements of the Pathway’s program will potentially be the model for 49 other states as part of our great federal Republican leadership’s Big Beautiful Bill, which kills Medicaid Expansion for over 20 million folks in those 40 states and also kills all ACA insurance premium subsidies for an additional 20 million hardworking folks including 1.4 Million hardworking Georgians, unless renewed by Dec 31, 2025. Talk about the blind leading the blind! Let’s follow Georgia’s Republican leadership off the cliff!

Max A. Black retired from the U.S. Navy after 31 years of service to his country. He is an Honor Graduate from the Elbert County Comprehensive High Class of 1975, went to Georgia Tech on a Navy R. O.TC. scholarship, and graduated with honors from the Terry School of Business at the University of Georgia.