After a federal judge denied Georgia’s request for an extended Medicaid deadline, thousands are now at risk of losing their health insurance coverage.
Georgia’s Pathways to Coverage program, unique for including a work requirement, is set to expire in September 2025. The state sought an extension to 2028 but failed to follow federal guidelines, leading to the judge’s ruling against the request.
The program has enrolled over 4,300 Georgians, with up to 345,000 eligible. Governor Brian Kemp’s office vowed to collaborate with Medicaid Services to safeguard Pathways’ future.
Pathways imposes a work requirement of 80 hours per month or engagement in volunteer work, school, or rehab. It also limits coverage to able-bodied individuals at a federal poverty rate of $15,060.
While Biden removed the work stipulation, Georgia successfully reinstated it in a lawsuit, shortening the Pathways deadline. With CMS rejecting extension requests due to procedural flaws, Wood upheld Biden’s ruling, stressing the need for adherence to extension protocols.
Failure to secure an extension could lead to financial strains on low-income Georgians forced to choose between healthcare and essential needs. Ryan emphasized the urgency for action to prevent coverage loss.
Georgia’s options include reapplying for an extension, expanding Medicaid under the Affordable Care Act, or devising a less restrictive plan for accelerated approval.
Fong highlighted the logical structure of the Pathways program but pointed out its exclusion of many who critically require Medicaid coverage.