Georgia became the only state to have a Medicaid work requirement in place when Georgia Pathways took effect on July 1, 2023. The work requirement policy, announced by the Georgia Department of Community Health (DCH) on July 5, 2023, expands Medicaid coverage to people below the Federal Policy Level (FPL) who complete certain work-related activities.
Georgia lawmakers in 2019 created Georgia Pathways through the passage of Senate Bill 106. The program aims to expand Medicaid coverage to qualifying adults with households below the poverty level that work at least 80 hours per week. The Centers for Medicare and Medicaid Services (CMS) approved Georgia’s plan in October 2020, effective July 1, 2021.
CMS later approved Georgia’s Medicaid expansion but rejected work requirements for eligibility. Georgia filed a lawsuit against CMS and HHS in the United States District Court for the Southern District of Georgia in January 2022, arguing in part that the Medicaid expansion was contingent on work requirements. The state proceeded to implement Georgia Pathways as initially approved by CMS, and the U.S. District Court for the Southern District of Georgia ruled in favor of the state on August 19, 2022.
