(The Center Square) – Georgia Democratic gubernatorial candidate Keisha Lance Bottoms outlined her plans to fund Medicaid expansion and chided her opponent as she stood on the debate stage alone Monday night.
Republican Rick Jackson declined to participate in the Atlanta Press Club debate.
“Rick Jackson is the first gubernatorial candidate not to stand here in 32 years,” Bottoms said in her opening statement. “He’d rather hide behind his billions than explain to you his record of making billions off the taxpayers of Georgia.”
A panel of journalists questioned Bottoms about her promise to expand Medicaid on her first day in office, asking how she would pay for it.
“The first thing we need to do is get rid of the waste in government in Georgia,” Bottoms said. “Right now, we are spending hundreds of millions of dollars on the Georgia Pathways program that is supposed to provide access to affordable healthcare to the people of Georgia. So the first thing that I will do will be to get rid of that Georgia Pathways program.”
Georgia is one of 10 states that did not expand Medicaid under the Affordable Care Act. Second-term Republican Gov. Brian Kemp led the development of Georgia Pathways, a program for low-income Georgians who don’t qualify for traditional Medicaid. It requires recipients to complete 80 hours per month of qualified activities, including work, education or community service. The program has 20,321 participants as of Aug. 31, according to the Georgia Department of Health.
A report from the U.S. Government Accountability Office released in September 2025 found that the state spent $54.2 million between October 2020 and March 2025 on administrative costs and just $26.1 million on providing medical assistance. The state received $47.4 million from the federal government and spent $6.7 million of its money to cover the administrative costs.
The state also overestimated how many people would sign up for the program, according to the report.
The Centers for Medicare and Medicaid Services agreed to extend the program until December.
Jackson said in a debate with Bottoms on Oct. 6 that he would expand Medicaid but didn’t give specifics.
“I just want to do it in a way that we don’t lose $4.5 billion that we’re currently getting for the state, because that would really hurt hospitals and doctors all over the state. But I will expand it,” Jackson said.
Bottoms said she would also eliminate tax breaks for data centers to expand Medicaid.
When asked where she would find the $11 million to $47 million needed in the first two years, Bottoms added she would look at state contracts.
“We’re going to look at every single contract that’s been handed out in this state and we’re going to determine how we can recapture money for the people of Georgia,” Bottoms said.
Bottoms has proposed a statewide moratorium on data centers for “as long as it takes for us to make an informed and responsible decision as to how we move forward as a state.”
Polls show Jackson leading Bottoms in a close race, according to 270towin.com. The latest from Wedgewood Polls shows Jackson ahead 51%-49%.
Early voting begins Tuesday and ends Oct. 30.