Elected Republicans may have declared war on leftists’ racist DEI ideology in state governments across the country. But that doesn’t mean the unelected bureaucracy isn’t fighting back.
That’s the main takeaway from a new report by the State Leadership Initiative (SLI), which documents how a pro-DEI organization known as the National Association of Medicaid Directors (NAMD) allied itself with the Peach State’s bureaucracy to alter “the entire trajectory of the Georgia Medicaid program by inserting California values into the bureaucratic process of Georgia, without a single elected official noticing.” Obtained by The Federalist, the new analysis underscores the danger of this unelected “shadow government” that “is incredibly effective at utilizing bureaucratic processes to govern.”
“The National Association of Medicaid Directors is an organization no one has ever heard of — but their members collectively oversee over $900 billion in government spending, the largest individual program of every state budget,” SLI Founder and President Noah Wall told The Federalist. “This organization has weaponized Medicaid by forcing woke policies into conservative states. No conservative state should subject their constituents to their extreme politics and underhanded way of weaponizing critical programs for their progressive ends.”
The SLI analysis begins by highlighting a March 2025 investigation by the Washington Free Beacon, which uncovered records showing how senior staffers at Georgia’s Department of Community Health (DCH) “hijacked” the state’s Medicaid bidding process for insurance providers to “insert a question related to transgender children.” “Insurers whose answers reflected left-wing policy priorities,” the outlet noted, “secured a piece of the multibillion-dollar contract … which is set to go into effect in mid-2026.”
As it turns out, that outcome appears to have been only made possible by the state bureaucracy’s under-the-radar alliance with NAMD — which has a history of touting leftist ideology.
According to the SLI analysis, “What goes uninvestigated in these reports is the undue influence of the National Association of Medicaid Directors via its members and ties to those who oversaw the bidding process, the primary suspect being Chief Health Policy Officer Lynette Rhodes.” As noted by the Free Beacon, Rhodes was one of the DCH staffers involved in inserting the trans-related question into Georgia’s Medicaid bidding process.
Per the SLI report, it was during the time in which Georgia’s “Medicaid contract process was internally being written by the DCH” in 2023 that Rhodes was elected president-elect of the NAMD. Rhodes, along with other DCH staff, “attended multiple NAMD events,” with the DCH shelling out “over $135,139 on employees for conference activity for these events,” according to data reviewed by SLI.
“This doesn’t include broader spending, employee training, professional development, and state membership dues Georgia pays to the NAMD,” the report reads.
What’s particularly notable about NAMD is the organization’s documented infatuation with DEI ideology.
As noted by SLI, in 2021, the NAMD listed “equity” as a “foundational principle for all reform,” which included a “focus on racial and ethnic minorities, rural populations, Tribal populations, and any other groups experiencing disparate health outcomes …” The organization’s podcast “Medicaid Leadership Exchange” also “has multiple episodes featuring the implementation of internal DEI task forces and initiatives in state programs, and Rhodes has her own episode featuring ‘Vaccine Equity,'” according to the report.
The “most concerning” aspect of NAMD, as noted by SLI, is the organization’s advocacy for “measuring the diversity of their provider networks and ensuring that state Medicaid programs work with ‘culturally aligned.'”
The good government group’s analysis cites a 2021 NAMD report that includes a section featuring various steps state Medicaid leaders can take to “support the development of a well trained, compassionate, diverse, and sufficient [long-term services and supports] LTSS workforce.” One of these “steps” advises these officials to “Evaluate and promote a diverse and culturally reflective workforce.”
“Some state Medicaid agencies are going beyond measuring if they have enough providers in their long-term care systems and are developing ways to measure the diversity of their provider networks and whether or not the providers are reflective of and culturally aligned with the person receiving the services,” the NAMD report reads.
[RELATED: New Report Shows Red State Institutions Are Just As Left-Wing As Their Blue Counterparts]
In a statement to The Federalist, Blake Bassham, the State Freedom Caucus Network’s research director for Georgia, noted how Georgia voters “elected Republicans to utterly destroy the woke agenda, and they expect our elected officials to uphold the platform they ran on.” He further demanded that the Peach State hold these “rogue bureaucrats” accountable for “pushing radical transgender ideology on children and enforcing racist DEI mandates with taxpayer dollars.”
“The facts are now public. The receipts are out. Time to drop a nuclear bomb on this woke garbage,” Bassham said. “The Georgia Freedom Caucus is leading the way on destroying the woke agenda. Now it’s time for the rest of our elected Republicans to follow their lead.”
SLI concludes its report by calling on Georgia’s state auditor and inspector general to “ensure that the actions taken reflect Georgia’s values and are unadulterated by foreign interest groups.” The good government group further encouraged the Peach State to end its membership with organizations like the NAMD and “no longer allow taxpayer dollars to be spent on Shadow Government conferences, training, and professional development.”
“Most importantly, there must be significant oversight of these departments’ actions, which can no longer be trusted to act in the best interests of the people,” the report concludes. “New regulatory priorities, policies, and contracts must be approved by a review from the elected officials of the state. The dissemination of ‘best practices’ from Shadow Government organizations like the NAMD and their implementation in state departments should be prohibited.”
SLI Georgia Shadow Govt Report by The Federalist
