Jamiesfeast – Georgia filed a lawsuit against the Biden administration on Friday, seeking an extension to provide healthcare access to low-income residents.
Georgia Governor Brian Kemp, a Republican, has taken legal action against the Centers for Medicare and Medicaid Services (CMS) and the United States Department of Health and Human Services (HHS). His objective is to reclaim the time that was lost due to what he perceives as a “stolen implementation time” from the Georgia Pathways to Coverage 1115 Demonstration Waiver.
Georgia officials are considering extending the program’s launch time by an additional three years. As of now, the program is scheduled to conclude at the end of September 2025.
Georgia Pathways, a program that commenced in July 2023, successfully extended Medicaid coverage to a significant number of low-income individuals in Georgia who were previously ineligible. However, the state claims that CMS (Centers for Medicare and Medicaid Services) caused a delay in the coverage by revoking certain crucial aspects of the program, despite having granted approval for the federal-state waiver back in October 2020.
Georgia Governor Brian Kemp expressed frustration with the Biden administration’s continued interference in the state’s healthcare plan. In a statement Kemp stated, “After the Biden administration’s lengthy, failed attempt to interfere with Georgia’s innovative plan to afford thousands of Georgians the opportunity to receive quality healthcare, they are back at it again. We beat them in court then, and now we are again asking for the federal government to adhere to the terms they agreed to rather than play politics by refusing to give us back the time they stole from delaying the Pathways rollout and implementation.”
DCH Commissioner Russel Carlson stated that the Department of Community Health (DCH) has been actively spreading awareness and assisting eligible Georgians in enrolling in suitable healthcare plans.
“I am pleased to commend Governor Kemp for his efforts in providing our team with the opportunity to further implement this groundbreaking program,” stated Carlson.
In 2019, Georgia passed the Patients First Act, which aimed to expand Medicaid coverage to individuals who were previously ineligible for such benefits. The Act granted the Department of Community Health (DCH) the authority to provide Medicaid coverage to this previously underserved population.
The Georgia Pathways program has expanded the eligibility criteria for Medicaid, offering coverage to individuals earning up to 100 percent of the federal poverty level, as opposed to the previous limit of 133 percent.
In 2020, CMS granted full approval for the new coverage, which was designed based on the existing Temporary Assistance for Needy Families federal program.
In a press release, the state of Georgia announced that weeks after Biden’s inauguration, CMS issued a letter stating that it was “reconsidering” the previous approval of Georgia Pathways.
In pursuit of this, Georgia initiated legal action to enforce the implementation of Georgia Pathways according to the original terms agreed upon. Subsequently, in August, a federal court ruled in favor of Georgia, granting the green light for the commencement of preparations for the launch of Pathways.
“In 2022, the governor expressed his dissatisfaction with their actions, claiming that they were engaging in an unlawful regulatory bait and switch. He argued that their decision was driven by politics rather than policy, as they sought to impose their top-down agenda on the American people.”
According to elected officials, the obstruction from the Biden administration was driven by political differences rather than a thorough examination of the policy’s consequences.
“The Biden administration’s decisions were driven by partisan politics rather than the law or sound public policy,” expressed Georgia’s Attorney General Chris Carr. He added, “We eagerly anticipate advocating for Georgia’s ability to offer practical healthcare solutions for our residents.”
As of December 15, 2023, the Pathways program had a total of 2,344 enrolled active beneficiaries.
According to Michael Giusti, an insuranceQuotes.com analyst, there has been a ongoing dispute between the Biden administration and Georgia regarding the “activity” requirement in the Georgia Pathways program.
According to Giusti, if Georgia manages to maintain its work requirement in Medicaid coverage, it could serve as a model for other southern states to follow.
“It’s truly unfortunate that as the Biden administration and Georgia engage in a back-and-forth, countless Georgians are left without access to healthcare,” he expressed with disappointment.