ATLANTA — Gov. Brian Kemp’s limited expansion of Medicaid, the Georgia Pathways to Coverage program, has so far enrolled 2,344 active beneficiaries as of Dec. 15, 2023. As previously reported by Channel 2 Action News, initial estimates from the state said about 100,000 Georgians may be eligible for its first year.
The program, which officially launched in July, added work requirements to some Medicaid benefits, making Georgia the first state in the country to do so.
Now, Kemp’s administration is suing the Centers for Medicare and Medicaid Services, and the administration of President Joe Biden, for what they say are delays and interference in program implementation.
“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,” Kemp said in a statement. “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.”
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The goal of the lawsuit, according to a statement from the governor’s office, is to extend the program’s launch time by three years, which they say were improperly taken from the program due to federal litigation and efforts to delay or prevent the Pathways launch.
In data previously shared with Channel 2 Action News, Georgia officials said “The allotted budget for enrollment in Pathways for FY2024 could fund coverage for roughly 100,000 individuals.”
During his January 2023 “State of the State” address, Kemp said “Here’s another fact, upwards of 345,000 Georgians could qualify for the Pathways program and healthcare coverage for the first time, with no changes for those who qualify for regular Medicaid. And unlike Medicaid expansion, Georgia Pathways will not kick 200,000 Georgians off their private sector insurance.”
However, in the lead-up to the launch of Georgia Pathways, the state’s Medicaid unwinding process removed hundreds of thousands of adults and children from their medical coverage, prompting federal officials to weigh in on the decline in enrollment.
U.S. Secretary of Health Xavier Becerra sent a letter to Kemp’s office saying that “as of September 2023, your data shows children’s Medicaid and CHIP enrollment in your state has declined by 149,080 children or 9% compared to March 2023.”
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Kemp’s office announced the lawsuit on Friday, following a series of efforts by the Biden administration to revoke Georgia’s Medicaid plan, citing potential missteps with potential broad consequences. The program is currently approved to run through September 2025 by CMS, but Georgia officials want to extend that to have the three years of missed implementation time returned.
“In August 2022, the federal court ruled in Georgia’s favor and allowed DCH to again begin preparations for Pathways’ launch. The program launched in July of 2023, years after its original planned implementation date,” the governor’s office said when announcing the lawsuit.
The federal lawsuit filed by Georgia says that the state requested CMS revise the Pathways’ end date to Sept. 30, 2028 back in February 2023, asking that CMS “reflect the 5-year demonstration originally agreed to.” Further, the lawsuit says that CMS officially denied approval of a revised end date in November, as well as a later denial to even reconsider the request in December.
Georgia claims that the issue with dates prevents Georgia from being able to fully complete the five-year demonstration period required of the program, laying the blame for this potential failure at the feet of the federal government and actions taken before the launch of the Georgia Pathways program.
The lawsuit also said denial of this revised date could lead to the effective loss of Medicaid services to thousands of Georgians, though it’s worth noting that in 2023, thousands of beneficiaries did lose coverage during the state’s unwinding period.
Now, Georgia is fighting the delays in court again and asking that CMS and the Biden administration allow the state three additional years to operate the Pathways program, for further data to prove the program is capable of meeting the needs of eligible Georgians.
The current end date for the Georgia Pathways Program, without federal revision, would be Sept. 30, 2025.
Channel 2 Action News has reached out to the White House and CMS for comment on the lawsuit’s claims. We are awaiting their response.
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