Frank Berry is retiring after six years of heading the state’s main health care agency.

He will be replaced by Gov. Brian Kemp’s deputy chief of staff for operations, Caylee Noggle, who will take over as commissioner of the Georgia Department of Community Health (DCH) on July 1.

Berry, 55, has been Community Health commissioner since 2016.

The agency runs the state Medicaid program as well as overseeing benefits for state employees, teachers, other school employees, retirees and dependents. As such, DCH handles the benefits of nearly 3 million Georgians, with an annual budget of $17 billion.

Before taking the position at DCH, Berry was commissioner of the state’s Department of Behavioral Health and Developmental Disabilities.

“I would like to thank Frank Berry for his 26 years of outstanding service in many different roles across state government,” Kemp said in a statement Tuesday. “Frank’s leadership, passion, and knowledge have served Georgia well and were invaluable during our fight against COVID-19. Commissioner Berry guided DCH through unprecedented challenges during his tenure and has left the agency better prepared to meet challenges in the years to come.”

The transition comes at a critical time for the agency and the Kemp administration.

The state is still awaiting federal officials’ decision on whether to approve a waiver plan to add low-income adults to the Georgia Medicaid program. Under previous President Donald Trump, the feds were favorable to the plan, but officials under President Joe Biden have been critical of it.

The federal Centers for Medicare and Medicaid Services (CMS) said this week that it is still completing the review of Georgia’s waiver, which has been scheduled to launch next month.

Other health care challenges include the continuing COVID pandemic and Georgia’s relatively low vaccination rate.

In addition, recent national ratings put Georgia at the bottom of states on health care.

The election for governor next year is expected to feature health care as a leading issue. Democrats have pushed hard for Medicaid expansion under the Affordable Care Act as an alternative that would cover many more people than the Kemp-backed waiver plan. Georgia’s Republican political leadership over the past decade has consistently rejected expansion, citing the costs of the move.

Prior to her current position, Noggle was interim chief of staff to the governor, and before that was interim chief of staff at the Georgia Department of Public Health and chief management officer for the Governor’s Office. Before joining the Kemp Administration in January 2020, Noggle served as president of the Georgia Student Finance Commission.

She is known for her strong operational expertise.

“Caylee Noggle has done a remarkable job throughout her service in state government – including in her integral role throughout the state’s response to the COVID-19 pandemic,” Kemp said. “Caylee brings years of in-depth knowledge and management expertise to a complex state agency that will greatly benefit from her diverse experience and leadership. ”

She will be joined at DCH by a new deputy commissioner, Ryan Loke, who has been Kemp’s chief health care adviser.

“At DCH, Ryan will continue to spearhead our implementation of Georgia Pathways and Access [the Georgia Medicaid waiver plan] as we work to provide quality, affordable health care for more hard-working Georgians,’’ Kemp said. “His passion for health care and experience successfully coordinating various aspects of our fight against COVID-19 will greatly benefit DCH and our state.”

The fate of that waiver, though, is up in the air.

Earlier this month, GHN reported that Georgia officials said they still were working toward a July 1 launch of the waiver plan to add more people to the state’s Medicaid program, despite a harsh initial assessment by the Biden administration. DCH said Tuesday that the state is “still progressing” toward implementing the waiver “pending further communications or guidance from CMS.”

The conflict with the feds involves the eligibility requirements that Georgia proposed and that the Trump administration approved.

Georgia’s waiver says that to get Medicaid coverage, a low-income adult must put 80 hours a month into a job, an education program, a volunteer organization or another qualifying activity. It is strongly backed by Kemp, who has called it “a ‘hand up’ for hard-working Georgians in our state who are more than deserving.’’

But a February letter from the CMS criticized Georgia’s policies “that condition health care coverage on meeting work or other community engagement requirements.’’

The Kemp administration fired back at the CMS letter, appealing the new federal position. The Georgia letter said the waiver’s possible revocation by the Biden administration would be “an arbitrary and unlawful bait-and-switch,’’ and would prompt a state challenge in court.

Other states with approved work requirements got similar federal letters. Later, CMS sent letters notifying Arkansas, Michigan, New Hampshire, and Wisconsin of its final decision to withdraw work requirement waiver authorities in those states, according to the Kaiser Family Foundation.

The Biden administration, meanwhile, has boosted the financial incentives for Medicaid expansion in an effort to persuade Georgia and the 11 other states that have held out against doing it.

Georgia’s two U.S. senators, Democrats Raphael Warnock and Jon Ossoff, have pushed the state to expand Medicaid, even working on legislation to create a federal workaround or to “pursue other strategies” to provide coverage in holdout states.

Warnock said recently that “as a result of our refusal to expand Medicaid, we are leaving about 500,000 Georgians who could get care in the [coverage] gap, leaving $110 million of revenue on the table, and leaving 64,000 jobs we could create by expanding Medicaid. What could be more urgent coming out of the pandemic?’’

Berry said in a statement Tuesday, “It has been the honor of a lifetime to spend my career in public service and touch the lives of so many. I want to express my gratitude to the entire DCH team for their tireless work over the years. I am proud of the progress and successes we have achieved together. I am equally grateful for the partnerships with our legislators, sister agencies, and stakeholders who continue to work collaboratively with the department on a variety of challenging health care issues.”