CMS approves extension of Georgia Pathways health coverage program

Governor Brian P. Kemp announced that the Centers for Medicare & Medicaid Services (CMS) has approved an extension of the Georgia Pathways to Coverage program. This program, run in partnership with the Georgia Department of Community Health (DCH), aims to increase access to affordable health coverage for able-bodied beneficiaries and reduce the uninsured rate in Georgia. Since its launch, Georgia Pathways has served 15,427 beneficiaries.

"We’re grateful to the Trump administration and CMS for this approval, which supports our innovative, Georgia-centric approach to providing healthcare coverage to thousands of hardworking Georgians," said Governor Brian Kemp. "Unlike the previous administration which chose to sue, obstruct, and delay, President Trump and his team have worked alongside us to improve Georgia Pathways and ultimately deliver a better program to Georgians who need it most. We look forward to continuing that partnership in the months ahead."

The extension will begin on October 1, 2025, allowing the program to continue through December 31, 2026. Updates include expanding eligibility so that parents and legal guardians of children under six enrolled in Medicaid are now considered as having a qualifying activity. Previously approved activities included working, volunteering, or educational pursuits.

Reporting requirements for members will also change; they will now only need to report qualifying activities at application and annual renewal rather than more frequently. This aligns reporting with other Medicaid programs in Georgia and is expected to lower administrative burdens for both participants and state agencies.

Additionally, a retroactive coverage policy will be implemented so that coverage starts from the first day of the month when an application is received.

The program was initially approved by CMS in 2019 but faced delays due to legal challenges from the Biden administration. These challenges were eventually defeated in court, allowing implementation in 2023 after federal Medicaid redetermination began. The timing resulted in higher initial costs but over 15,000 people have already benefited from participation.

Recent improvements mandated by H.R. 1 of Congress earlier this year have made other states consider adopting similar models based on Georgia’s experience.

For further details about Pathways or information on how to apply for coverage under this program visit https://pathways.georgia.gov/.

The Department of Community Health oversees Medicaid and PeachCare for Kids programs covering more than two million Georgians each year with an annual budget exceeding $20 billion. More information about DCH can be found at https://dch.georgia.gov/.