This story was updated with additional comment at 11 a.m. Friday, June 4.
The Biden administration has flagged another significant part of Gov. Brian Kemp’s health care plan, with the latest federal pushback focused on the governor’s plan to bypass healthcare.gov and send consumers directly to insurance companies or brokers.
The setback comes as the governor awaits word on whether the state can move forward with a slight expansion of Medicaid for those who satisfy a work or activity requirement. In that case, the Kemp administration has vowed to defend the state’s proposal.
The Centers for Medicare and Medicaid Services sent a letter to Kemp Thursday saying part of this second waiver plan “requires further evaluation” and requesting updated analysis by early next month. The state’s response will then be subjected to a 30-day comment period.
The state also has the option of amending its plan.
“We are still reviewing the letter,” the governor’s spokesman, Cody Hall, said when reached late Thursday.
The federal government raised several concerns about the state’s plan to circumvent the federal marketplace under the Affordable Care Act in favor of a list of insurers and brokers that consumers could consult, including how uninsured Georgians would be made aware of the site.
This part of the waiver proposal also sparked opposition during the public comment period last summer, including from those who said they found the state’s replacement plan confusing.
Georgia Congresswoman Carolyn Bourdeaux, a Suwanee Democrat, called the delay “welcome news” in a statement Thursday.
“If implemented, (the governor’s plan) would block the use of Healthcare.gov, potentially jeopardizing information about affordable health care coverage for hundreds of thousands of Georgians,” Bourdeaux said.
“After this 30-day review period, I strongly urge the Biden Administration to permanently rescind this waiver. We should be making it easier to find information about health insurance coverage — not harder,” she added.
The feds also argued that enrollment through healthcare.gov is now on the rise in Georgia, partly due to a special enrollment period for the pandemic, and that this trend is expected to continue after eligibility was expanded and assistance increased under the American Rescue Plan Act this spring. The federal coronavirus relief bill also included new federal incentives to fully expand Medicaid, which GOP state leaders have so far rebuffed.
Kemp’s waiver proposals were approved last fall, which brought former President Donald Trump’s CMS director, Seema Verma, to the state Capitol for a ceremonial signing. Shortly after that, Trump lost his bid for another term.
“Since that time, there have been changes in both health care priorities and policies, as well as federal law,” the letter said, referring to executive action taken by President Joe Biden and the sweeping coronavirus relief bill passed in March.
The pandemic has also intensified the need to ensure Americans have “meaningful access to affordable coverage and care,” the letter said.
But there was also a bit of good news for the governor in the letter: Kemp’s plan to create a reinsurance program designed to attract more insurers to underserved areas of the state and lower premiums can continue without further evaluation. The program is set to start this January.
Laura Harker, senior policy analyst with the Georgia Budget and Policy Institute, said Friday that the letter is “a step in the right direction to ensure no one loses access to care.”
Harker said the state’s plan lacks details on how the private sector would invest in the outreach needed to boost enrollment while ensuring that people would not be steered toward short-term plans or options that cover fewer services.
“Hopefully, this letter, the state’s updated analysis and the resultant public comment period will lead the state to reevaluate its plan to remove itself from healthcare.gov, and instead pursue commonsense options to improve access to care, such as focusing on the reinsurance program in the first phase of the state’s plan and covering over half a million Georgians with full Medicaid expansion,” she said.