Gov. Brian Kemp’s proposal would bypass healthcare.gov and send consumers looking for insurance to a privately run process. But the federal government stopped short of pulling the plug on the plan Friday. Jill Nolin/Georgia Recorder
The governor’s stalled health care plan hit another roadblock Friday when the Biden administration notified state officials it could soon block a proposal to bypass healthcare.gov.
The state has so far not responded to three letters seeking additional information, which “alone constitutes a sufficient basis” to suspend implementation of the program, according to a letter from Chiquita Brooks-LaSure, administrator for the Centers for Medicare and Medicaid Services.
The federal agency is also arguing that major changes have been made since the state plan was approved in 2020 by the Trump administration, leading to more Georgians signing up for health care through the individual marketplace.
More than 700,000 Georgians had signed up or re-enrolled in Affordable Care Act plans during the enrollment period that ended in mid-January. That was a 36% increase from the prior year.
The Biden administration has attributed the growing enrollment partly to special sign-up opportunities during the COVID-19 pandemic and more federal spending on consumer outreach. Last spring’s American Rescue Plan Act also included enhanced subsidies, which have helped cut premiums.
An analysis done for the federal government by a private firm, Acumen, concluded participation would decrease under Gov. Brian Kemp’s plan, with enrollment dropping up to 8.3% in the first year. Brooks-LaSure also noted concerns raised during a recent public comment period.
So far, only one part of the governor’s health care proposals unveiled in 2019 – a reinsurance program designed to reduce premiums – has taken effect.
The Biden administration rejected major parts of the governor’s plan to slightly expand Medicaid eligibility, and the state is challenging that decision in federal court.
Kemp’s proposal would bypass healthcare.gov and divert consumers looking for insurance to a privately run process. But the federal government stopped short of pulling the plug on the plan Friday.
“The departments are committed to working with Georgia to make change to the Georgia Access Model to ensure enrollment does not decrease in the state under the waiver, which is why the departments have afforded the state an opportunity to rectify the Georgia Access Model, rather than terminate the Georgia Access Model at this time,” Brooks-LaSure wrote.
The state has until July 28 to submit an updated plan detailing how it would guarantee a smooth transition for Georgians and avoid the projected drop in enrollment.
Laura Colbert, executive director of Georgians for Healthy Future, a consumer advocacy nonprofit, urged Kemp to use the pause as an opportunity to reconsider the waiver.
“There are more Georgians enrolled in coverage through the Affordable Care Act than ever before. Any plan that would meaningfully disrupt health insurance for 700,000 folks should be carefully considered,” Colbert said.
“Georgia leaders are not giving Georgians the courtesy of careful consideration when they refuse to answer questions about their plan to separate from healthcare.gov, and disregard evidence that it will mean some hard-working Georgians lose their coverage. Under these circumstances, it’s reasonable for the federal government to hit the brakes,” she added.
Two groups that challenged the plan in court last year, Planned Parenthood Southeast and Feminist Women’s Health Center, celebrated the Biden administration’s decision Friday. In a joint statement, the groups said Kemp’s plan “seeks to turn back the clock for Georgians trying to enroll in quality health care to a time when consumers were forced to navigate through private insurers, brokers, and junk plans just to get covered.”
Georgia Democrats like U.S. Sen Raphael Warnock had called on the Biden administration to scrap the plan.
“After months of effort, I’m glad the Administration is heeding my call to reverse course on this misguided decision that would undoubtedly lead to fewer Georgians having less access to free and affordable health care,” Warnock said in a statement Friday.
The governor’s office did not respond to a request for comment sent late Friday.
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