MICHEL MARTIN, HOST:
Under the Republicans' new tax and spending law, people on Medicaid face new requirements. That includes work requirements for low-income adults. Although others have tried, Georgia is the only state that currently has this. WABE's Jess Mador looks into how it's going.
JESS MADOR, BYLINE: Tanisha Corporal isn't opposed to work requirements in principle. But then she left her job as a social worker to start her own nonprofit.
TANISHA CORPORAL: I would have never thought that I was going to run into the challenges that I did with trying to get approved because I'm, like, I know the process.
MADOR: Corporal had prediabetes and other medical concerns.
CORPORAL: Because I have breast cancer in my family history, so it was like, I got to get my mammograms.
MADOR: Then Corporal learned she qualified for Georgia's Pathways to Coverage program. It offers Medicaid to adults up to the federal poverty line if they can prove they're working, in school or volunteering at least 80 hours a month. She was volunteering at least that much. So she gathered up her documents to verify her duties and hours and applied via the online portal.
CORPORAL: And we were denied.
MADOR: Corporal has a master's in social work. But even she ended up spending around eight months fighting to get into the program, uploading documents only for them to bounce back or seemingly disappear in the portal. Here's just one of the denial letters she got.
CORPORAL: Your case was denied because you didn't submit the correct documents, and you didn't meet the qualifying activity requirement.
MADOR: It was difficult reaching anyone at the state Medicaid agency to explain why.
CORPORAL: Or they'll say they called you. And we look at our call log. I'm like, nobody called me. And, like, the letter will say, you missed your appointment, and it'll come on the same day.
MADOR: Corporal's application was finally approved, only after she spoke about her experience at a public hearing covered by Atlanta news outlets. Now she has Medicaid, but she still has to recertify she's working or volunteering every month.
CORPORAL: Even once I got through the red tape and got approved, now maintaining it is bringing another level of anxiety.
MADOR: Laura Colbert leads the advocacy group Georgians for a Healthy Future. She says Corporal's experience is typical.
LAURA COLBERT: People just can't get enrolled in the first place. And some folks who do get enrolled lose their coverage because the system thinks they didn't file their paperwork or there's been some other glitch.
MADOR: She says reporting every month requires reliable internet access or transportation, both things low-income Georgians might not have. A spokesperson for Georgia's Department of Human Services said in an email that the state is rolling out a number of tech fixes to improve the process. Joan Alker is a health policy expert at Georgetown University. She says when Arkansas tried work requirements in 2018, it didn't go well. More than 18,000 people lost their coverage after failing to comply with the new requirements.
JOAN ALKER: A lot of the problems were similar to Georgia in terms of the website closed at night. People couldn't get ahold of people.
MADOR: And, Alker points out, national work requirements are unlikely to boost employment. More than two-thirds of Medicaid recipients already work anyway. The rest are mostly students or people too sick or disabled to work.
ALKER: Work requirements don't work except to cut people off of health insurance.
MADOR: And they cost a lot to implement. Georgia's been running Pathways to Coverage for two years. The enrollment system alone has cost more than $50 million, and right now just under 7,500 people are enrolled.
For NPR News, I'm Jess Mador in Atlanta.
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MARTIN: This story comes from NPR's partnership with WABE and KFF Health News. Transcript provided by NPR, Copyright NPR.
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