ATLANTA– Georgia sued the Biden administration on Friday to try to keep the state’s new health plan for low-income residents, the only Medicaid program in the country with a work requirement, that runs until 2028.
Georgia Pathways launched in July and will expire at the end of September 2025.
The lawsuit filed in U.S. District Court in Brunswick, Georgia, says the Biden administration’s decision to rescind the work requirement and another aspect of Pathways have delayed the program’s implementation. This reduced the originally approved duration of the program from five years to just over two years.
A judge later ruled that the revocation was illegal.
“This case centers on whether the federal government can profit from its own unlawful conduct,” the lawsuit said.
It seeks an injunction compelling the U.S. Centers for Medicare and Medicaid Services to extend the Pathways program until September 30, 2028. A CMS spokesperson said in an email that the agency does not comment on pending litigation.
CMS denied the extension request in October and again in December. The agency could not take it into account because the state had not met the requirements to apply for an extension, including a public notice and comment period, CMS Deputy Administrator and Director Daniel Tsai said in a Dec. 22 letter.
Georgia Governor Brian Kemp said in a press release announcing the lawsuit that the Biden administration was once again trying to “interfere with Georgia’s innovative plan.” He accused the government of playing politics “by refusing to give us back the time they stole by postponing the elections. Rollout and implementation of processes.”
In his December letter to the state, Tsai said the agency did not prevent Georgia officials from implementing other aspects of Pathways when it rescinded the work requirement and withdrew a plan to charge some Medicaid recipients monthly premiums. And he said an implementation period that was shorter than the originally approved timeline was not unique to Georgia.
“Many states are experiencing delayed implementation of their demonstration projects (or initiatives within a demonstration project) for various reasons,” he said.
Georgia’s plan provides health care coverage to able-bodied adults earning up to the poverty line: $14,580 for an individual or $24,860 for a family of three. But people must document 80 monthly hours of work, study, rehabilitation or volunteer work to qualify.
Republicans have presented the plan as a financially responsible alternative to a full expansion of Medicaid services under the Affordable Care Act, although opposition to full expansion appears to have weakened. Georgia is one of 10 states without broader Medicaid coverage.
The Kemp administration estimates that Pathways could add 100,000 poor and uninsured Georgia residents to the Medicaid list, but enrollment has been slow so far, with just under 2,350 people enrolled as of mid-December.
The work requirement was approved by the administration of then-President Donald Trump, but the Biden administration announced in December 2021 that it would revoke that approval and the premium requirement. That prompted Georgian officials to file a lawsuit.
A federal judge reinstated both parts of the program in 2022, saying the revocation was arbitrary and capricious.