The state of Georgia filed a federal lawsuit against the Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services (HHS) on February 2, 2024, to obtain an extension on the state’s Medicaid program—currently the only state program in the country with a work requirement. 

Georgia Pathways to Coverage, an experimental Medicaid expansion program, was first approved by the Trump administration and requires enrollees to participate in 80 hours per month of work, education, job training, or community service. CMS later rescinded approval of the program under the Biden administration due to the work requirements, but a federal court ruled in Georgia’s favor in 2022. 

Georgia Pathways launched in July 2023 and is set to expire in September 2025. Citing the legal delays, Georgia requested a three-year program extension, but CMS rejected it twice last year. 

Daniel Tsai, the deputy administrator and director of CMS, denied the delays as justification for an extension, writing that “many states experience delayed implementation of their [Medicaid programs] for various reasons.”

Governor Brian Kemp responded with a federal lawsuit, claiming “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.”

For more information on Medicaid work requirements, click here.