CMS Approves Georgia Pathways to Coverage™ Extension, Further Validates Innovative Approach

ATLANTA - Governor Brian P. Kemp, in partnership with the Georgia Department of Community Health (DCH), announced today that the Centers for Medicare & Medicaid Services (CMS) has approved an extension of the Georgia Pathways to Coverage™ program. This innovative and Georgia-centric approach has been a key health initiative that increases access to affordable health coverage for able-bodied beneficiaries, lowers the uninsured rate across Georgia, and supports members on their journeys to financial independence. Since it launched, 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, and will allow the program to continue through December 31, 2026. It includes updates designed to expand access to coverage and improve the experience for eligible low-income Georgians. Key updates include:

• Parents and legal guardians of children under six and enrolled in Medicaid will now be considered an additional qualifying activity, in addition to the previously approved qualifying activities of working, volunteering, and educational pursuits.
• Members will now only be required to report qualifying activities and hours at application and at annual renewal to continue their coverage. This will align with reporting requirements of other Medicaid programs in Georgia and reduce administrative burdens on both beneficiaries and the state.
• A retroactive coverage policy will be established for the Pathways to Coverage program, meaning coverage will now begin on the first day of the month in which an application is received.

Though first approved by CMS in 2019, the Georgia Pathways to Coverage program launch was delayed by repeated legal challenges from the Biden administration. Each of those legal challenges was defeated and implementation was finally granted in 2023, but only after the federally-mandated Medicaid redetermination process commenced. Combined, these obstructionist legal delays and launch during the redetermination process culminated in greater upfront costs for the program. Nevertheless, over 15,000 Georgians have already benefited from the program, and in accordance with the improvements mandated by H.R. 1 of the U.S. Congress earlier this year, other states are now looking to Georgia's model as a path to follow for their own Medicaid programs.

For more information about Pathways, visit https://pathways.georgia.gov/ . To apply, visit gateway.ga.gov. Applicants may also apply by phone at 1-877-423-4746 or 711 for those who are deaf, hard of hearing, deaf-blind, or have difficulty speaking; in-person at your local Division of Family & Children Services (DFCS) office: dfcs.ga.gov/locations; or by mail to your local DFCS office.

About the Georgia Department of Community Health

The Department of Community Health serves as the lead agency for Medicaid and PeachCare for Kids®, which, combined, cover more than 2 million Georgians annually. The agency also oversees the State Health Benefit Plan, Healthcare Facility Regulation Division, and the State Office of Rural Health, among other divisions, accounting for an annual budget of over $20 billion. Through effective planning, purchasing, and oversight, DCH provides access to affordable, quality health care to some of the state's most vulnerable and underserved populations. To learn more about DCH and its commitment to Shaping the Future of a Healthy Georgia, visit https://dch.georgia.gov/.