A federal judge has sided with Georgia that the Biden administration unfairly struck down the state’s Medicaid work requirements program.
The ruling, issued late Friday, overturns the Centers for Medicare & Medicaid Services’ (CMS') decision to a controversial program first approved by the Trump administration.
“Despite the left’s efforts to claw back good policy for partisan politics, this week the judiciary ruled the Biden administration erred in striking down our innovative healthcare waiver which would better serve Georgians than a one-size-fits-all Medicaid expansion,” tweeted Republican Gov. Brian Kemp on Friday.
The state argued in its initial filing back in January that the work requirements program was already approved by the Trump administration back in October 2020. It argued that CMS didn’t have the authority to rescind the work requirement provision when it approved certain parts of the Medicaid expansion waiver on Dec. 23, 2021.
Federal Judge Lisa Godbey Wood ruled that CMS’ decision late last year to just get rid of the Medicaid work requirements was arbitrary and capricious.
“The agency measured Pathways against a baseline of full Medicaid expansion, rather than taking the demonstration on its own terms,” the filing said.
Wood added that the agency failed to explain why it had changed its mind from the prior approval.
She ruled that CMS violated federal law by not engaging in “reason decision-making” and therefore set aside the decision to reject the work requirements program.
CMS in December 2021 said the COVID-19 pandemic had made it extremely difficult for individuals to meet the work requirements but left in place the Medicaid expansion coverage portion of the waiver.
The agency said last year that work requirement programs in other states had created a confusing and burdensome requirement on Medicaid beneficiaries. For example, more than 18,000 beneficiaries lost Medicaid coverage in Arkansas due to the implementation of that state’s program.
Federal courts have also struck down similar programs in more than a dozen states, with several ruling that the program violates the Medicaid statute for not providing care to all eligible beneficiaries. Wood, however, wrote that the December 2021 CMS decision should be set aside because the agency also failed to consider the possibility that the waiver rejection could lower Medicaid coverage in Georgia.
“If Pathways increases Medicaid coverage in Georgia, then it inescapably follows there would be more Medicaid coverage in Georgia with Pathways than without it,” the ruling said.
Since the agency failed to consider or weigh the possibility that rescinding the Pathways to Coverage program could mean less Medicaid coverage, CMS’ decision is arbitrary and capricious, according to the ruling.
CMS did not immediately return a request for comment on whether it will appeal the decision.
The Supreme Court did not take up a case surrounding the legality of Arkansas' work requirements program back in April, after it had canceled oral arguments for a similar case in 2021.