Georgia Sues HHS Over Medicaid Work Requirement Repeal

King & Spalding

On January 21, 2022, Georgia sued HHS over its withdrawal of the approval of the work requirement policy as a requirement for Medicaid eligibility in the Georgia Pathways to Coverage demonstration. As previously reported, in December 2021, CMS formally rescinded its approval of the qualifying hours requirement. One month later, Georgia has now sued HHS and CMS in the Southern District of Georgia to enforce the terms under which Georgia’s Pathways was originally approved.

In October 2020, HHS approved Georgia’s Pathways, a Section 1115 Demonstration Project, that would create an enrollment opportunity for more than 50,000 Georgia families to gain Medicaid eligibility so long as they met and continued to satisfy a minimum number of qualifying hours through work, job training, education, volunteering, or other similar activities. Medicaid work requirements were approved in Georgia and 11 other states by HHS during the Trump administration, which made such requirements a policy priority.

Under the Biden administration, HHS now rejects the work requirements as a violation of the Medicaid statute that compromised the effectiveness of the coverage expansion in light of the ongoing disruptions caused by the COVID-19 pandemic. Thus, in February 2021, CMS sent Georgia a letter indicating that it was reconsidering its previous approval of Georgia’s Pathways and had preliminarily determined the qualifying hours requirement did not further the objectives of Medicaid.

The complaint filed by Georgia against HHS is available here.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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