This article was produced for ProPublica’s Local Reporting Network in partnership with The Current GA. Sign up for Dispatches to get stories like this one as soon as they are published.
Margaret Coker, The Current
Last summer, as political debate swirled over the future of Georgia’s experiment with Medicaid work requirements, Gov. Brian Kemp held a press conference to unveil a three-minute testimonial video featuring a mechanic who works on classic cars.
Luke Seaborn, a 54-year-old from rural Jefferson, became the de facto face of Georgia Pathways to Coverage, Kemp’s insurance program for impoverished Georgians. In a soft Southern drawl, Seaborn explained how having insurance had improved his life in the year that he had been enrolled: “Pathways is a great program that offers health insurance to low-income professionals like myself.”
Kemp lauds Pathways as an innovative way to decrease the state’s high rate of uninsured adults while reining in government spending, holding the program up as an example to other Republican-led states eager to institute Medicaid work requirements.
But in the nine months since Seaborn’s video testimonial was released, his opinion of Pathways has plummeted. His benefits have been canceled — twice, he said, due to bureaucratic red tape.
“I used to think of Pathways as a blessing,” Seaborn recently told The Current GA and ProPublica. “Now, I’m done with it.”
Rather than an enduring symbol of success, Seaborn’s experience illustrates why the program struggles to gain traction even as the state spends millions of dollars to burnish Pathways’ brand. The Current GA and ProPublica previously reported that many of the approximately 250,000 low-income adults potentially eligible for the health insurance program struggle to enroll or maintain coverage.
The politics of Pathways were not on Seaborn’s mind when he received a phone call last summer from an insurance executive who handles Pathways clients. One of the first Georgians to enroll in the program in 2023, Seaborn had written a letter thanking his insurance provider for covering a procedure for his back pain. The executive from Amerigroup Community Care wanted to know: Would he take part in a promotional video for Pathways?
Seaborn, a supporter of the governor, said yes without hesitation. Soon afterward, Kemp’s press secretary, Garrison Douglas, arrived at his auto repair shop, located a few miles from the governor’s hometown, and spent hours filming in the garage filled with vintage Ford and Chevy trucks and handpainted gas station signs.
A trained chemical engineer, Seaborn had quit his corporate job to embrace his dream of repairing classic cars. But the realities of being a small business owner made that path difficult, Seaborn said, especially when it came to shouldering the cost of health insurance for himself and his son. Pathways eased the way, he said.
Seaborn said he was surprised when the governor called him out by name weeks later at the press conference during which his testimonial video was released. He wasn’t expecting to be the singular face of Pathways.
By November, though, Seaborn encountered some of the problems that other Georgians say have soured their opinion on Pathways. Seaborn said he had logged his work hours into the online system once a month as required. But his benefits were canceled after he failed to complete a new form that he said the state had added without adequate warning. Seaborn said the form asked for the same information he had been submitting every month, just in a different format. The state’s Medicaid agency did not respond to questions about Seaborn’s experience or the new form.
He said he called the same insurance executive who had asked him to take part in the testimonial. She told him she would be lunching with one of Kemp’s aides that day and promised to help, he recalled. Within 24 hours, Seaborn said, his benefits were restored, and a representative from Georgia’s Division of Family and Children Services, which administers federal benefits programs, called to apologize.
Douglas said the governor’s office “had no involvement in Mr. Seaborn’s case.” The insurance company did not respond to requests for comment.
Pathways enrollees must submit paperwork every month proving they had completed the requirements necessary for coverage: 80 hours of work, study or volunteering. But the state says it is not verifying the information on a monthly basis — only during enrollment and upon annual renewal.
Seaborn said that after his coverage was restored, his insurance company told him he would no longer have to file his work hours monthly; the next time he would need to submit such documentation would be during his annual reenrollment. Nevertheless, Seaborn said he signed up for text and email notifications from the Pathways program so that he wouldn’t be caught off guard if requirements changed again.
Even so, technical glitches and more red tape caused him to lose his coverage once more, he said. He stopped receiving texts from the Pathways program in February. When he logged in to the digital platform in early March to make sure everything was in order, a notice informed him that his benefits would be terminated on April 1. The reason: he had missed filing an annual income statement. He said the surprise requirement had popped up on the digital platform even though his coverage was not up for renewal.
“My head exploded,” he said. “I didn’t get a text or an email. I did what I was supposed to, but that wasn’t good enough.”
Seaborn said he went ahead and filed the information, although it was late. He tried to call his insurance provider again for an explanation — and help. He reached out to the Division of Family and Children Services as well. This time, however, he said no one called him back.
In April, Seaborn paid out of pocket for his and his son’s prescription medications, an extra $40 that he said is difficult for him to afford.
Ellen Brown, a spokesperson for Georgia’s Division of Family and Children Services, would not say why Seaborn’s benefits were terminated.
“We are sorry to hear this happened and are looking into how we can better serve our customers and resolve communication gaps in the future,” Brown said in a written statement Friday. “Every Georgian that seeks our services is important, and we take these matters very seriously.”
Meanwhile, Seaborn received a phone call that day from the same Division of Family and Children Services representative who had apologized to him after he was kicked off Pathways last fall. He said she told him she would make sure he got his coverage back. The representative did not respond to a request for comment from The Current and ProPublica.
On Monday evening, Seaborn received a text message to alert him to a notification in the Pathways digital platform. He logged on: A notice confirmed that he had been reenrolled, a change of fortune that he credited to The Current GA’s and ProPublica’squestions to state officials about his predicament because he had already given up on contacting people for help.
“I am so frustrated with this whole journey,” Seaborn said. “I’m grateful for coverage. But what I don’t understand is them leaving me like a mushroom in the dark and feeding me nothing, no information, for more than a month.”
This story comes to GPB through a reporting partnership with The Current.
