What Georgia’s Medicaid Work Requirement Tells Us About the Costs of the “Big Beautiful Bill” — ProPublica

Congress -Republican, seeking ways to compensate for tax reductions, seek mandate to make millions of Americans work to get a federal subsidized health insurance. The Goop Taxation Bill adopted the House in May, and the Senate Republicans are feverishly working to promote the federal costs in the coming days.

Georgia, Only a state with a mandate to work MedicaidHe started experimenting with the demand on July 1, 2023. As the two -year anniversary of the Medicaid program approaches, Georgia recorded only part of those The system of verification of the state’s work. As of May 2025, approximately 7,500 of almost 250,000 Georgians were credited, although state statistics show that 64% of this group are working.

Governor Brian Kemp has long advocated the reform of Medicaid, claiming that the country should move away from public care. His press -secretary also told the current and propublica that the program known as “Georgia” before covering, never been designed to maximize enrollment.

Health Analysts and Former State officials Medicaid say Georgia’s experience shows that the bill on Congress, if it becomes a law, would cost taxpayers hundreds of millions of administrative costs as it is carried out by threatening health care for medical care Almost 16 million people.

Here’s how the proposed federal work requirements are compared to Georgia – and how they can affect your state:

How will the state determine who has the right?

What Congress offers:

A HomeHR 1 and the Senate project proposal requires all states to make sure that Americans between the ages of 19 and 64, who receive Medicaid healthcare, spend 80 hours a month, working, training, studying or volunteering. These new check systems must be created by December 31, 2026, and will have to check the status of the enrolled residents twice a year. This means that people who already receive coverage, based on their income level, need to prove their right regularly – or lose insurance.

Federal work requirements will apply up to more than 10 million low -income adults covering Medicaid, as well as approximately 5 million inhabitants of 40 states who have accepted federal subsidies to people to acquire private healthcare through what is commonly known as Obamacare.

The bill of the House of Representatives releases parents with children to 18 years from new requirements, while the Senate version releases parents with children under 15. Neither Bill releases people who look after the elderly relatives.

Georgia’s experience:

Georgia’s mandate extends to fewer categories of people than the proposed federal legislation. However, officials did not meet the hard -monthly requirements of the state check for ways of ways out of technical failures and difficulties that confirm the employment of those who work in the informal economy, such as home and landscape purifiers because they may not pay plugs and tax records. The problems were rather steep that Georgia decided to weaken its work checks from every month.

What does it mean to your state:

According to the Congress budget estimates 10 million Americans with low income Loss of health insurance. Healthcare fans say this is not because they do not work, but from the bureaucratic hoops, they will need to go to prove work. Studies from kffThe Analytical Health Policy Center shows that the vast majority of people who will obey the new law already work at school or are unpaid care tutors, responsibilities that limit their ability to earn salaries elsewhere.

Arkansas is the only staff except Georgia that has implemented work requirements. Later, the republican states changed their minds after the data showed that the red one, related to the check, led to the fact that more than 18,000 people lost coverage during the first few months after politics. The federal judge stopped the program in 2019, deciding that it increased the state insurance rate without any evidence of increasing employment.

Speaker of the House of Representatives Mike Johnson, Republican Louisiana, says Medicaid’s job requirements in HR 1 are “common sense“He says that policy will not lead to health losses for Americans who were originally developed because the requirements do not apply to these groups: children, pregnant women and elderly people who live in poverty indicates the decades of the decades that lead to work in the country.

Who will pay for the work verification system in each state?

What Congress offers:

The bill on the wards allocates $ 100 million to help the states pay the check systems that determine anyone’s right. The grants will be distributed in proportion to each state in Medicaid students subject to new requirements – the number of experts on health issues – this will not be enough. According to them, the states will be hooked for the sake of difference.

Georgia’s experience:

Two years after the launch of the work experiment, Georgia spent almost $ 100 million in the main federal funds for the implementation of the ways. Of this, $ 55 million went to create a digital system to check the right of participants – more than half the number of Republicans who are allocated for the whole country to do the same.

As in other states, Georgia already had a work check system for food programs but it is concluded in contract with Deloitte Consulting To process new Medicaid requirements. Georgia’s representatives said the state spent 30% more than expected, to create its digital way for the rise of the consultant and this expenses. Previously, Deloitte refused to answer questions about his ways.

What does it mean to your state:

According to three former Medicaid officials who are already checking the requirements for the recipients of the food brand, but many existing systems will need modernization. In 2019, when the states last considered job requirements, A Survey at non -partisan government accounting showed that Kentucky expects administrative costs up to higher $ 200 million – twice as much as HR 1 allocated for the country.

The Republican Republican, representing coastal Georgia and chairmen with the Subcommittee of the Health and Trade Committee, which recommended to reduce Medicaid in HR 1, said the advances that carry the states will be offset by long -term savings promised in the bill. Some Republicans Congress acknowledge that cost savings will come from fewer people coming to Medicaid from new requirements. Working mandates savings 43% of $ 793 billion in Medicaid’s proposed cuts, Congressional budget reports.

How will the states cooperate with the program?

What Congress offers:

Medicaid is a federal network social security program that is conducted in each state. Neither the HR 1 nor the legislative proposal of the Senate gives the basics of how the states have to check the matching or how the cost of control over new requirements will be paid.

Georgia’s experience:

Georgia’s experience shows that state -owned employees are key to managing applications and work requirements for residents entitled to Medicaid. The Federal Enrollment Agency had approximately 20%of vacancies when Georgia started its policy of work in 2023 in 2023. Georgia at the time had one of the longest waiting time to approve federal benefits. As of March, the agency had a lag with more than 5,000 applications. The agency said he would need another 300 affairs workers, and this is upgrading to better manage the lag, according to Report presented by state legislators in June.

What does it mean to your state:

Former Medicaid government officials and health experts say the fight against Georgia is not unique. In 2023, closer to the end of the COVID-19 public health emergency, KFF surveyed states on the level of personnel schedule for cases checking the right to federal benefits, including Medicaid. Worker Vacant rates exceeded 10% in 16 of the 26 states that responded; The rates exceeded 20% in seven of these states.

Adding cases will mean higher costs for states. Currently, 41 states require a balanced budget, which means that these legislators need to increase taxes and revenues to check Medicaid students or reduce enrollment to reduce costs, said Joan Alker, Executive Director of the Children and Families of Georgetown.

Approximately half a dozen large states where the county’s governments conduct federal security programs, the cost of training workers on new checks can go from the states to the constituencies.

“There are provisions that are very, very difficult, if not impossible for us to implement,” said Senator Lisa Murkovsky, a republican, Alaska, in June, about the costs facing her state to meet the accounts in the House.