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Georgia sues Biden admin in a bid to keep the only Medicaid program in the country with a work requirement active

Georgia – Georgia has initiated legal action against the Biden administration in an effort to keep its unique Medicaid program, known as Georgia Pathways, which is known for being the only one in the United States to incorporate a work requirement for low-income residents. This legal challenge, lodged on a Friday, marks a significant moment in the ongoing debate over healthcare provisions and work mandates.

The lawsuit, filed in the U.S. District Court in Brunswick, Georgia, aims to ensure the continuation of the Georgia Pathways program until September 2028. The program, which launched in July, is currently scheduled to expire at the end of September 2025. Georgia’s contention with the Biden administration revolves around the decision to revoke the work requirement, an action that Georgia claims unlawfully shortened the program’s duration from its originally approved five years to just over two years.

This case underscores a broader national conversation on the intersection of healthcare access and employment requirements. The Biden administration’s move to revoke the work requirement, alongside another aspect of the Pathways program, prompted immediate backlash from Georgia officials. They argue that this revocation not only delayed the program’s implementation but also unjustly trimmed its operational lifespan.

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The controversy reached a judicial crossroads when a judge declared the revocation of the work requirement illegal, stating, “This case is about whether the federal government can benefit from its own unlawful conduct.” Georgia’s lawsuit now seeks a court order to mandate the U.S. Centers for Medicare and Medicaid Services (CMS) to extend the Pathways program’s life.

Despite the legal turmoil, CMS has remained silent on the issue, adhering to its policy of not commenting on pending litigation. The agency had previously rejected Georgia’s extension request twice, citing procedural shortcomings, including the absence of a public notice and comment period as reasons for their decision.

Georgia Governor Brian Kemp has been vocal in his criticism of the federal government’s actions, accusing the Biden administration of political interference and of hindering the state’s innovative approach to Medicaid expansion. Kemp’s administration is pushing back against what they see as federal overreach, insisting on reclaiming the time lost due to the delayed rollout of the Pathways program.

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The heart of the Pathways plan is to provide healthcare coverage to able-bodied adults below the poverty line, contingent on their completion of 80 hours per month of work, study, rehabilitation, or volunteering. This model is presented by Republicans as a cost-effective alternative to the full expansion of Medicaid under the Affordable Care Act—a stance that has seen fluctuating levels of opposition within the party.

Despite its ambitions, the Pathways program has faced challenges in reaching its enrollment targets. Since its inception, the program has seen a modest uptake, with fewer than 2,350 individuals enrolled by mid-December, far below the Kemp administration’s projection of 100,000 beneficiaries.

The legal and administrative hurdles faced by Georgia Pathways reflect the complexities of implementing healthcare reforms that deviate from federal norms. As Georgia pursues this lawsuit, the outcome will likely have implications for the future of Medicaid work requirements and state-federal dynamics in healthcare policy across the nation.

Calliope Hargrave



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