Georgia Fights for Healthcare Innovation: Lawsuit Filed Against Federal Government Over Delayed Implementation of Georgia Pathways Program

ATLANTA (AP) – Georgia has filed a lawsuit against the Centers for Medicare and Medicaid Services (CMS) in an effort to regain lost time for the implementation of the Georgia Pathways program. The state claims that CMS’s decision to rescind core elements of the program, despite a previously approved federal-state waiver, has unjustly delayed the expansion of Medicaid coverage to tens of thousands of low-income Georgians.

The Georgia Pathways to Coverage initiative, a result of the bipartisan passage of Georgia’s Patients First Act in 2019, aimed to provide Medicaid coverage to previously ineligible individuals. The Georgia Department of Community Health (DCH) was granted the authority to carry out this program in collaboration with the Office of the Governor and members of the Georgia General Assembly. After multiple public comment periods, CMS approved Georgia Pathways in October 2020, affirming it as a binding contract between Georgia and the federal government.

However, shortly after President Biden’s inauguration, CMS notified Georgia that it was reconsidering its approval of the program. In December 2021, CMS officially rescinded its approval of the qualifying hours and premium requirements at the heart of Georgia Pathways. In response, the state filed a lawsuit in January 2022 to challenge the federal overreach and allow for the implementation of the previously agreed-upon terms. The federal court ruled in Georgia’s favor in August 2022, permitting DCH to resume preparations for the program’s launch.

Despite the victory in court, the implementation of Georgia Pathways faced significant delays. The program eventually launched in July 2023, years later than originally planned. The DCH has since intensified its outreach efforts and is now grappling with both the belated rollout of the program due to federal interference and the redetermination process necessitated by the expiration of the federal public health emergency.

Governor Brian Kemp expressed his frustration with the Biden administration’s actions, reiterating the state’s commitment to providing quality healthcare to Georgians. Department of Community Health Commissioner Russel Carlson commended Governor Kemp for his efforts in securing the opportunity to continue implementing this innovative program. The state of Georgia is seeking to reclaim the time that was lost and hold the federal government accountable to the agreed-upon terms.

To access the full details of the lawsuit, interested parties can request a copy of the complaint from [email protected].

Georgia’s legal action highlights the ongoing battle between states and the federal government over the implementation of Medicaid programs. The outcome of this lawsuit could have implications on the ability of states to expand Medicaid coverage and exercise autonomy over their healthcare systems. The lawsuit serves as a reminder of the challenges faced by states as they navigate the complex intersection of federal and state powers in healthcare policy.