Judge reinstates work requirement in Georgia Medicaid plan

ATLANTA (AP) — In a victory for Georgia’s Republican governor, a federal judge on Friday reinstated a work requirement in the state’s plan to expand Medicaid coverage to more low-income residents.

U.S. District Judge Lisa Godbey Wood said the Biden administration’s decision to revoke approval of the work requirement and a related Georgia proposal to charge some Medicaid recipients monthly premiums was “arbitrary and capricious on numerous, independent grounds.”

She called the revocation “unlawful” and set it aside.

The work requirement was approved by then-President Donald Trump’s administration, but the U.S. Centers for Medicare and Medicaid Services Centers announced last year that it was revoking approval of that part of the plan and the premium requirement. That prompted Georgia officials to sue.

CMS does not comment on litigation as a matter of policy, the agency said in an email.

Georgia Gov. Brian Kemp — who proposed the Medicaid plan at issue — hailed the ruling, saying in a Tweet that his plan would “better serve Georgians than a one-size-fits all Medicaid expansion.”

CMS had argued the work requirement could be impossible for people to meet during the pandemic, when it was critical that low-income Georgians have access to health coverage.

Wood said the agency failed to consider or weigh the possibility that rescinding approval would “mean less Medicaid coverage in Georgia.”

She also said CMS wrongly measured the Georgia plan against a full Medicaid expansion and “failed to explain why it changed its mind about the key issues underlying the approval.”

Republicans had presented Georgia’s plan as a financially responsible alternative to a full expansion of Medicaid services under the Affordable Care Act, which dozens of states have already done.

The plan sought to add an estimated 50,000 poor and uninsured Georgia residents to the Medicaid rolls in its first two years. But to be eligible, new Medicaid recipients would have to engage in a minimum number of qualifying hours through work, job training, education, volunteering, or other similar activities.

Democrats in Georgia say full expansion would cover hundreds of thousands of people at a much lower cost to the state. That’s because the ACA, President Barack Obama’s signature health care law, gave states the option of expanding Medicaid to low-income adults who make up to 138% of the federal poverty level, with the federal government picking up 90% of the cost. More than 10 million people in the U.S. have gained coverage that way.

Kemp has said full expansion would cost the state too much money in the long run.


This story has been corrected to reflect that CMS announced it was revoking approval of the work and premium requirements last year, not last month.