Georgia Pathways Faces Uncertain Future
Georgia has filed a lawsuit against the Biden administration in an effort to preserve its new health plan, Georgia Pathways, which is the only Medicaid program in the country with a work requirement. The program, launched in July, is currently set to expire in September 2025. However, Georgia is seeking an extension until September 2028.
Biden Administration Accused of Unlawful Conduct
The lawsuit, filed in U.S. District Court in Brunswick, Georgia, argues that the Biden administration’s decision to revoke the work requirement and another aspect of Pathways has unlawfully delayed the implementation of the program. The suit claims that the originally approved five-year term has been reduced to just over two years. Georgia is seeking a court order to compel the U.S. Centers for Medicare and Medicaid Services (CMS) to extend the program.
Dispute Over Extension Request
CMS rejected Georgia’s extension request in both October and December, citing the state’s failure to meet the necessary requirements, including a public notice and comment period. Georgia Governor Brian Kemp criticized the Biden administration, accusing them of interfering with the state’s innovative plan and refusing to give back the time lost due to the delayed rollout and implementation of Pathways.
Georgia’s Unique Approach to Medicaid
The Georgia Pathways program provides healthcare coverage to able-bodied adults earning up to the poverty line. However, to be eligible, individuals must document 80 monthly hours of work, study, rehabilitation, or volunteering. Republicans have positioned the plan as a fiscally responsible alternative to a full expansion of Medicaid services under the Affordable Care Act, although opposition to full expansion appears to be waning. Georgia is currently one of 10 states without broader Medicaid coverage.
The work requirement was initially approved by the Trump administration, but the Biden administration revoked that approval, along with a premium requirement, in December 2021. Georgia officials promptly filed a lawsuit. A federal judge later reinstated both parts of the program, deeming the revocation arbitrary and capricious.
The outcome of this lawsuit will determine the future of Georgia Pathways and could have broader implications for Medicaid programs across the country.