Judge rules against extension for Georgia’s Pathways to Coverage Medicaid work program

ATLANTA — A federal judge has dismissed the State of Georgia’s lawsuit against the U.S. Centers for Medicare and Medicaid Services over how long the state can operate its work-requirement Medicaid program.

In court, the judge granted summary judgment to CMS, ruling against the state.

“If Georgia wants to extend the program beyond the September 30, 2025, deadline, it has to follow the rules for obtaining an extension,” Judge Lisa Godbey Wood wrote, dismissing the case.

Pathways to Coverage in Georgia was the first Medicaid program in the country to add work requirements to some of the health benefits.

Since the program’s launch in July 2023 to Dec. 15, 2023, the most recent data available from the state’s online Pathways tracker showed just 2,344 people had enrolled in the program, though the site is currently showing up as under maintenance.

Data through December 2023 was pulled through a July 10 archived version of the webpage.

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.”

In the year since the program’s launch, the Associated Press reported that Pathways to Coverage has more than what’s been reported on the state site, instead saying there were 4,300 members.

However, the AP also reported that if Georgia were to fully expand Medicaid, as 40 other states have, then about half a million Georgians would be eligible for state-managed health insurance.

The current end date for the Georgia Pathways Program, without federal revision, would be Sept. 30, 2025.

A spokesman for Gov. Brian Kemp said in part that the state “will continue to pursue the necessary time to demonstrate the program’s viability by working with CMS. Just as before, we remain committed to this Georgia-specific, innovative initiative that leads not only to healthcare coverage but to better opportunity and coverage options for those who enroll in the program.”