ATLANTA (AP) — A federal judge ruled that the Biden administration followed the law when it rejected an extension Georgia's one-year Medicaid planwhich is the only one in the country that requires recipients of publicly financed health insurance for low earners to work.
The state did not comply with federal rules for an extension, which is why the Biden administration has legally denied its request to extend the expiration date of the Georgia Pathways to Coverage program from September 2025 to 2028, U.S. Magistrate Judge Lisa Godbey Wood ruled Monday.
Republican Gov. Brian Kemp's office said it would work with the Centers for Medicare & Medicaid Services to “continue to take the time necessary to demonstrate the viability of the program.”
“We remain committed to this Georgia-specific, innovative initiative that will result not only in health care coverage, but also in better opportunities and insurance options for those who enroll in the program,” spokesman Garrison Douglas said in a statement.
Georgia Pathways requires all recipients to have completed at least 80 hours of work, volunteer work, schooling or vocational rehabilitation each month. It also limits coverage to able-bodied adults who earn no more than the federal poverty level, which is $15,060 for a single person and $31,200 for a family of four.
The Biden administration revoked the work requirement in 2021, but Wood later reinstated it in response to a lawsuit from the state. Georgia sued the government again in February, arguing that the decision to revoke the work requirement and another aspect of Pathways delayed implementation of the program. This shortened the program's originally approved five-year duration to just over two years.
The Centers for Medicare & Medicaid Services twice rejected Pathways' renewal application, saying the state had not met the requirements for an extension application, including a public notice and comment period. Georgia argued that it intended to modify the program so that these requirements should not apply.
In her most recent ruling, Wood said the state had actually filed an extension request. She agreed that the Biden administration's decision to revoke portions of Pathways had delayed implementation, but said that a “previous bad act” did not allow the state to “now circumvent the rules and regulations for extensions.” “.
“If Georgia wishes to extend the program beyond the September 30, 2025 deadline, it must follow the rules for obtaining an extension,” she wrote.
Pathways got off to a rocky start. Georgia officials estimated it could now provide health insurance to 25,000 low-income residents, or possibly tens of thousands more. But last month, enrollment was just over 4,300.
Critics consider the workload to be too burdensome. Advocates say Pathways needs more time.
