Georgia Files Lawsuit Against Federal Agencies Over Delayed Medicaid Expansion

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Georgia Governor Brian P. Kemp directed the state to file a lawsuit against the Centers for Medicare and Medicaid Services (CMS) and the United States Department of Health and Human Services (HHS), along with related parties in the Biden administration. The lawsuit, filed in the United States District Court for the Southern District of Georgia Brunswick Division, aims to reclaim time lost in the implementation of Georgia Pathways to Coverage (Georgia Pathways) 1115 Demonstration Waiver.

The Georgia Pathways program, designed to extend Medicaid coverage to tens of thousands of low-income Georgians who were previously ineligible, faced delays due to CMS rescinding core elements of the program. Despite an approved federal-state waiver in October 2020, CMS’s decisions caused significant delays in launching the program.

Governor Kemp expressed frustration, stating, “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.” He emphasized the need for the federal government to adhere to agreed-upon terms rather than playing politics.

Department of Community Health Commissioner Russel Carlson commended Governor Kemp for his efforts and highlighted the work done to enroll eligible Georgians in the program.

The Georgia General Assembly’s bipartisan passage of the Patients First Act in 2019 granted the Department of Community Health the authority to expand Medicaid coverage. This initiative was a result of careful negotiations between the governor’s office, related departments, and members of the General Assembly.

Despite multiple public comment periods and federal approval in October 2020, CMS later rescinded its approval, causing further delays. The State of Georgia filed suit in January 2022 to allow implementation based on the agreed-upon terms. A federal court ruled in Georgia’s favor in August 2022, enabling the launch of the program in July 2023, years after its originally planned implementation date.

DCH has intensified outreach efforts while navigating the challenges posed by federal overreach and the redetermination process required by the expiration of the federal public health emergency.