{"id":831,"date":"2025-08-04T09:00:00","date_gmt":"2025-08-04T09:00:00","guid":{"rendered":"http:\/\/www.dangeladvertising.com\/?p=831"},"modified":"2025-08-08T15:00:12","modified_gmt":"2025-08-08T15:00:12","slug":"work-requirements-and-red-tape-ahead-for-millions-on-medicaid","status":"publish","type":"post","link":"http:\/\/www.dangeladvertising.com\/index.php\/2025\/08\/04\/work-requirements-and-red-tape-ahead-for-millions-on-medicaid\/","title":{"rendered":"Work Requirements and Red Tape Ahead for Millions on Medicaid"},"content":{"rendered":"

Now that the Republicans\u2019 big tax-and-spending bill has become law<\/a>, new bureaucratic hurdles have emerged for millions of Americans who rely on Medicaid for health coverage. A provision in the new law dictates that, in most states, for the first time, low-income adults must start meeting work requirements to keep their coverage.<\/p>\n

Some states have already tried doing this, but Georgia is the only state that has an active system using work requirements to establish Medicaid eligibility \u2014 and recipients must report to the system once a month.<\/p>\n

When she first started using the system, Tanisha Corporal<\/a>, a social worker in Atlanta, wasn\u2019t opposed to work requirements \u2014 in principle.<\/p>\n

But when she left her job at a faith-based nonprofit to start her own project, the Be Well Black Girl Initiative<\/a>, she needed health coverage. She soon came face-to-face with how daunting it can be to prove you are meeting the state\u2019s work requirements.<\/p>\n

\u201cI would have never thought that I was going to run into the challenges that I did, with trying to get approved, because I\u2019m like, I know the process,\u201d Corporal said. \u201cI\u2019ve been in human services.\u201d<\/p>\n

Corporal has been a social worker for more than two decades in Georgia and was familiar with the state\u2019s social service programs. For years, it had been her job to help others access benefit programs.<\/p>\n

But her challenges with paperwork and the process had only begun.<\/p>\n

Health advocates point to Georgia\u2019s system as a sign that the new law will lead to excessive red tape, improper denials, and lost health coverage.<\/p>\n

Beginning in 2027, the law will require adults on Medicaid who are under 65 to report how they engaged in at least 80 hours per month of work, education, or volunteer activities. Alternatively, these adults could submit documentation showing they qualify for an exemption, such as being a full-time caregiver.<\/p>\n

Most states will have to set up verification systems similar to Georgia\u2019s, which can be expensive to implement and run<\/a>. In the two years since launching its program, Georgia has spent more than $91 million in state and federal funds, according to state data<\/a>. More than $50 million of that was spent on building and operating the eligibility reporting system. Right now, just under 7,500 people are enrolled in Georgia.<\/p>\n

For Corporal, 48, forgoing coverage wasn\u2019t an option. She had been diagnosed with pre-diabetes and had other medical concerns.<\/p>\n

\u201cI have breast cancer in my family history,\u201d she said. \u201cSo it was like, I gotta get my mammograms.\u201d<\/p>\n

On paper, it looked as if she qualified for Georgia\u2019s program, called Georgia Pathways to Coverage<\/a>.<\/p>\n

It offers Medicaid to adults \u2014 who otherwise wouldn\u2019t qualify for traditional Medicaid in Georgia \u2014 with incomes up to the federal poverty level ($15,650 per year for an individual, or $26,650 per year for a family of three), as long as they can show that for at least 80 hours a month they\u2019re working, attending school, training for a job, or volunteering.<\/p>\n

Corporal was eager to apply. She was already volunteering at least that much, including with the nonprofit Focused Community Strategies<\/a>, and helping with other South Atlanta<\/a> community improvement efforts.<\/p>\n

She gathered up the various documents and forms needed to verify her duties and volunteer hours, then submitted them through Georgia\u2019s online portal<\/a>.<\/p>\n

\u201cAnd we were denied. I was like, this makes no sense,\u201d said Corporal, who has a master\u2019s degree in social work. \u201cI did everything right.\u201d<\/p>\n

In the end, it took eight months fighting to prove that she and her son, a full-time college student in Georgia, qualified for Medicaid. She repeatedly uploaded their documents, only for them to bounce back or seemingly disappear into the portal. She went through numerous rounds of denials and appeals.<\/p>\n

Corporal recently pulled up one of the denial notices on her cellphone to read aloud: \u201cYour case was denied because you didn\u2019t submit the correct documents. And you didn\u2019t meet the qualifying activity requirement,\u201d she read from the email.<\/p>\n

When she tried to call the state Medicaid agency for answers, it was difficult reaching anyone who could explain what was wrong with her application paperwork, she said.<\/p>\n

\u201cOr, they\u2019ll say they called you, and we look at our call log. Nobody called me,\u201d she said. \u201cAnd the letter will say, you missed your appointment, and it\u2019ll come on the same day\u201d as it was scheduled.<\/p>\n

Corporal\u2019s Pathways to Coverage application was finally approved in March after she spoke about her experience at a public hearing<\/a> covered by Atlanta news outlets.<\/p>\n

When asked about the delays and difficulties Corporal experienced, Ellen Brown<\/a>, a spokesperson for Georgia\u2019s Department of Human Services, emailed this statement: \u201cDue to state and federal privacy laws, we cannot confirm or deny our involvement with any person related to a benefits case.\u201d<\/p>\n

Brown added that Georgia is implementing tech fixes to streamline the uploading and processing of participants\u2019 documents. They include \u201crolling out a refresh to the Gateway Customer Portal<\/a> in late July that will include easier navigation and training videos for users as well as built-in prompts to ask customers to upload required documents.\u201d<\/p>\n

Now that Corporal has coverage, she is having to recertify her volunteer hours every month using the same glitchy reporting system. It\u2019s stressful, she said.<\/p>\n

\u201cIt\u2019s still a nightmare, even once I got through the red tape and got approved,\u201d Corporal said. \u201cNow maintaining it is bringing another level of anxiety.\u201d<\/p>\n

But she wonders how anyone without her professional background manages to get into the program at all.<\/p>\n

\u201cI think the system has to be simplified,\u201d she said.<\/p>\n

Because Georgia set up its work requirement before the recently passed law, it needed permission from the federal government through a special waiver.<\/p>\n

It is now seeking an extension of that waiver<\/a> to continue the Pathways program beyond its current expiration of September 2025. In the application, officials said they would reduce the frequency<\/a> by which participants needed to reverify their hours from once a month to once per year.<\/p>\n

But for now, Corporal\u2019s experience remains typical. And many health advocates fear it will be replicated under Trump\u2019s budget law with its new national Medicaid work mandate.\u00a0<\/p>\n

\u201cIn Georgia, we have seen that people just can\u2019t get enrolled in the first place. And some folks who do get enrolled lose their coverage because the system thinks they didn\u2019t file their paperwork or there\u2019s been some other glitch,\u201d said Laura Colbert<\/a>,<\/a> who leads the advocacy group Georgians for a Healthy Future<\/a>.<\/p>\n

Another state, Arkansas, tried work requirements in 2018.<\/p>\n

But it didn\u2019t go any better<\/a> there, said Joan Alker<\/a>, who leads the Center for Children and Families at Georgetown University.<\/p>\n

\u201cA lot of the problems were similar to Georgia,\u201d she said, \u201cin terms of the website closed at night, people couldn\u2019t get a hold of people.\u201d<\/p>\n

Some Republicans who backed the spending and tax legislation said the idea behind the national Medicaid work mandate was to ensure that as many people as possible who can work, do work. And to eliminate what the Trump administration deems waste, fraud, and abuse.\u00a0<\/p>\n

\u201cWhat we\u2019re doing is restoring common sense to the programs in order to preserve them because Medicaid is intended to be a temporary safety net for people who desperately need it,\u201d U.S. House Speaker Mike Johnson<\/a> said during a June appearance on \u201cThe Megyn Kelly Show.\u201d \u201cYou\u2019re talking about the elderly, disabled, you know, young single pregnant moms who are down on their luck, right? But it\u2019s not being used for those purposes because it\u2019s been expanded under the last two Democrat presidents and to cover everybody. So, you\u2019ve got a bunch of able-bodied young men, for example, who are on Medicaid and not working. So what we\u2019re doing is restoring work requirements to Medicaid. OK, this is common sense.\u201d <\/p>\n

National work requirements are unlikely to actually boost employment, Alker said, because more than two-thirds<\/a> of Medicaid recipients ages 19-64 already have jobs. The remainder includes students, or those who are too sick or disabled to work.<\/p>\n

\u201cWork requirements don\u2019t work, except to cut people off of health insurance,\u201d she said.<\/p>\n

The logistical steps required to report one\u2019s activities assume that a recipient has reliable internet or transportation to travel to an agency \u2014 things that low-income Georgians may not have.<\/p>\n

The paperwork requirements to gain coverage are time-consuming, said one Medicaid recipient, Paul Mikell<\/a>.<\/p>\n

Mikell is a licensed truck driver but does not have coverage through that job. He\u2019s also an electrician who currently does property maintenance in exchange for free housing.<\/p>\n

Mikell has had Medicaid through Pathways for nearly two years and has had problems navigating the Pathways web portal.\u00a0<\/p>\n

\u201cAnd I know it wasn\u2019t my device because I would go to the library and use the computer, I would try different devices, and I\u2019ve had the same issues,\u201d he said. \u201cRegardless of the device, it\u2019s something with the website.\u201d<\/p>\n

Another time, he said, his attempt to recertify his work hours was delayed because of paperwork issues.<\/p>\n

\u201cThey said I was ineligible for everything because of a typo in the system or something, I don\u2019t know what it was. I eventually was able to speak to someone and she fixed it,\u201d he said.<\/p>\n

This article is from a partnership with\u00a0WABE<\/a> and\u00a0NPR<\/a>.<\/em><\/p>\n

KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\n

USE OUR CONTENT<\/h3>\n

This story can be republished for free (details<\/a>).<\/p>\n","protected":false},"excerpt":{"rendered":"

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