Georgia’s plan to block parts of Obamacare questioned by Feds

Since being implemented in the country by then President Barack Obama, the Affordable Care Act (ACA) marketplace has been seen as an important health care reform that has provided access to health insurance for hundreds of thousands of uninsured each year in the state of Georgia. The federal health insurance program, also known as Obamacare, has been a partisan issue since its establishment, where one side wants to strengthen it and the other wants to chip away or totally repeal it, with citizens caught in the middle. The Biden administration has Georgia under a microscope as they question Gov. Brian Kemp’s proposed changes that would block Georgians’ access to the healthcare.gov shopping website.

Kemp’s waiver proposals for the ACA insurance marketplace were originally approved by the Trump administration in 2020 and set to go into effect over the next two years. This marks the second time in 2021 that one of the governor’s health care “waiver” proposals, previously approved by the former administration, has run afoul of the Biden administration. The other was Kemp’s plan to alter Medicaid in Georgia, which was placed on pause in January. Both proposals from Kemp were viewed as controversial changes that would not be supported by Biden.

Kemp proposed that when Georgians try to shop for insurance plans on the ACA marketplace website healthcare.gov, that they be blocked from shopping there and instead, redirected to a list of private insurance agencies or companies where they could shop. Kemp and Georgia are being directed to re-evaluate some of its previously presented data on the issue and submit a new analysis by July 3. This follows the U.S. Centers for Medicare and Medicaid Services reference to changes in the environment that have occurred since Kemp first filed his proposed changes. This includes changes in Georgia’s insured population, in federal spending on marketing and outreach to promote enrollment, and in federal rules that relate to the ACA. That data includes information on the age, income and health insurance status of the relevant state population, along with an explanation of the key assumptions the state used to develop estimates of the effect of the Georgia access model.

Said the federal government in its letter to Georgia, “In its application, Georgia neither quantified the size of the expected investment by the private sector nor indicated any specific commitments by the private sector to engage in outreach and marketing.”

Federal law allows the President to waive some parts of health care law to better serve an individual state’s citizens, however, ACA waivers by law must stay within certain “guardrails,” including that they will not harm coverage and will not increase the federal deficit. The data that the letter asked Georgia to provide could show whether the waiver would still meet those guardrails, given the recent changes.

A less controversial provision in Kemp’s ACA waiver called “reinsurance,” has been left alone by the Biden Administration, which calls for a state subsidy to insurance companies that could lower premium costs, especially for higher-income policyholders. Lower prices for policyholders are expected in November 2022 as they begin shopping for 2023 plans.

More than 500,000 Georgians got their 2021 insurance on the marketplace, and most of them bought their plan on the federal website.

The Georgia ACA waiver is already the subject of a federal lawsuit by advocates for the federal health insurance program who filed suit in January challenging Georgia’s plan to block access to coverage through the program’s online marketplace.