Judge’s ruling could cause thousands to lose health insurance

Thousands of people are at risk of losing their health insurance after a federal judge denied Georgia’s request to extend Medicaid.

President Joe Biden’s administration previously rejected Georgia’s request to extend parts of its Medicaid program, the only one in the nation that includes work requirements for recipients.

Georgia’s “Path to Insurance” program is set to expire in September 2025. The state had requested to extend the program until 2028 but failed to follow proper federal rules regarding extensions, U.S. Judge Lisa Godby Wood ruled this week.

Pathways has enrolled more than 4,300 Georgians in the program, and state officials previously said as many as 345,000 people were eligible.

In response, Georgia Governor Brian Kemp’s office said it would continue to work with the Centers for Medicare and Medicaid Services (CMS) to keep Pathways open.

“We are grateful that Judge Wood’s ruling reaffirms what we have been saying all along: the Biden Administration’s decision to roll back parts of the Georgia Pathways program and delay its implementation appropriately recognized it as ‘bad practice,'” Kemp spokesman Garrison Douglas said. Newsweek.

“Pursuant to the remainder of her ruling, we will continue to work with CMS to pursue the time necessary to demonstrate the feasibility of the program. As always, we remain committed to this Georgia-specific, innovative effort that will not only expand health insurance coverage, but also create better opportunities and insurance choices for those who participate in the program.”

The Pathways program differs from other Medicaid coverage in that it requires recipients to work at least 80 hours a month or participate in volunteer work, school or rehabilitation.

Pathways also sets its coverage limit for able-bodied individuals at the federal poverty level of $15,060 for a single person.

Biden repealed the work requirement in 2021, but Georgia was able to restore the original rule in a lawsuit, which shortened Pathways’ five-year limit to just over two years.

CMS has already denied Georgia’s extension request twice, saying the state did not meet its rules for requesting an extension. Specifically, CMS requires public notice and comment periods.

Wood reinstated Biden’s ruling that Georgia didn’t meet the requirements, saying the state “will now not be permitted to circumvent the rules and regulations that provide for the extended time.”

“If Georgia wants to extend the program beyond the Sept. 30, 2025 deadline, it must follow the rules for obtaining an extension,” Wood wrote.

Michael Ryan, a financial expert and founder of michaelryanmoney.com, said the core issue between Georgia and the Biden administration is procedural.

“Georgia has failed to follow federal rules requiring public notice and comment on Medicaid changes,” Ryan said. Newsweek. “The judge is essentially saying, ‘The rules are the rules, even for the states.'”

If thousands of people lose their health insurance because of the shorter deadline, Ryan predicts health care costs will rise as more people put off treatment until they have an emergency.

He also said that without Medicaid, countless families could go bankrupt because of unexpected medical bills.

“Low-income Georgians could be forced to make an impossible choice between health care and other necessities,” Ryan said. “This is not just a health issue, it’s a financial stability issue.”

Georgia has a choice: It can reapply for an extension, following the due process Wood outlined, consider a full Medicaid expansion under the Affordable Care Act, or it can come up with a new, less restrictive plan that could be approved more quickly, Ryan said.

“It puts recipients in a difficult position, but at the same time, it’s hard not to hold the government accountable,” said Alex Bean, a financial literacy lecturer at the University of Tennessee at Martin. Newsweek.

“The good news is that Georgia lawmakers say there’s still hope they can work out some kind of deal if they act quickly. The problem is that the government rarely acts quickly on anything, which could lead to thousands of beneficiaries losing their insurance. If you’re in this group, you’d better start considering your options if a deal to expand coverage doesn’t come to fruition.”

Chris Fong, a Medicare expert and CEO of Smile Insurance Group, said while the Pathways program makes sense structurally as it stands, “it leaves out a lot of people who desperately need Medicare.”

“It appears the judge denied the postponement on procedural grounds,” Fong said. Newsweek“It doesn’t seem like Georgia can’t fix the problem, but it will take time to go through the public notice and comment phase. If the Georgia Pathways program isn’t extended, the 4,300 people enrolled will be forced to find health insurance elsewhere.”