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The state of Georgia and the federal government remain at loggerheads over Gov. Brian Kemp’s limited expansion of the state’s Medicaid program.

The state filed a lawsuit in federal court in Brunswick Friday seeking an extension of the five-year program being denied by the federal Centers for Medicare and Medicaid Services (CMS).

The agency approved Georgia Pathways in October 2020 during the Trump administration. The program provides coverage to Georgians with incomes up to 100% of the Federal Poverty Level – a lower threshold than the Affordable Care Act (ACA), which covers those with incomes up to 138% of the poverty level.

Unlike the federal Medicaid program, Georgia Pathways also requires enrollees to participate in at least 80 hours per month of “qualifying” activities, including work but also education, job training, or community service.

In 2021, after Democrat Joe Biden succeeded Republican Donald Trump in the White House, CMS rescinded its approval of Georgia Pathways because of the work requirement. The state sued, and in a 2022 ruling won the right to proceed with the program.

The Georgia Department of Community Health (DCH) launched Georgia Pathways last July and requested an extension of the program – now due to expire next year – citing the delays in implementation caused by CMS’ change of course under the Biden administration.

Last October, CMS denied the request for an extension of the end date, prompting the lawsuit filed Friday.

“After the Biden administration’s lengthy, failed attempt to interfere with Georgia’s innovative plan to afford thousands of Georgians the opportunity to receive quality health care, they are back at it again,” Kemp said.

“We beat them in court then, and now we are again asking for the federal government to adhere to the terms they agreed to rather than play politics by refusing to give us back the time they stole from delaying the Pathways rollout and implementation.”

Democrats in the General Assembly have pointed to sluggish enrollment in Georgia Pathways in arguing the state should fully expand Medicaid coverage instead through the ACA, as 40 other states have done.

In a news release Friday, Kemp said the DCH has ramped up efforts to enroll eligible Georgians in Georgia Pathways and noted the timing of the rollout has been complicated by coinciding with the Medicaid eligibility redetermination process required by the expiration last spring of the COVID-related federal public health emergency.