Georgia has a new plan to ditch ACA exchanges
Governor Brian Kemp’s Georgia Access Model would have consumers buy insurance directly from providers or utilize a web broker.
When the Affordable Care Act was first enacted, it gave states the choice between participating in a federally run marketplace for individual insurance plans (Healthcare.gov), or creating their own state-based marketplace. In recent years, many states have opted to quit the federal exchange in favor of creating their own.
Now, however, the state of Georgia wants to quit its participation in Healthcare.gov, period. Governor Brian Kemp’s revised Georgia Access Model would instead have consumers buy insurance directly from providers or utilize a web broker. The state would determine who is eligible to enroll in plans and receive subsidies.
Related: Feds put brakes on Georgia plan to ditch ACA exchanges
Critics say the move would hamper consumers’ ability to compare plans, and, according to an analysis from the Brookings Institute could lead to a drop of nearly 100,000 in overall enrollment.
“You would really just be pulling out one piece of the ACA that is so important to folks, which is the single one-stop-shop marketplace, and not replacing it with anything,” Katie Keith, a principal at health-care policy advisory firm Keith Policy Solutions LLC, said in an interview with Bloomberg Law.
The state disagrees, saying the move would lead to an estimated 25,000 increased enrollees “through improved customer service, outreach, and education provided by the private market.” It argues that the private sector is better positioned to provide customer service and increase options for consumers to purchase health care coverage.
According to the proposal, “Allowing multiple, private web-brokers to participate will create competition and provide market incentives to offer improved plan/product selection and enrollment assistance, as well as local, customized customer service to attract uninsured individuals into the market.
“Web-brokers are typically paid on commission for enrollment, creating strong market incentives to provide education and outreach to drive enrollment and reduce the number of uninsured without cost to the state,” the proposal adds.
The state has applied for an innovation waiver from the Centers for Medicare & Medicaid Services, which will accept comments on the proposal until Sept. 16 and issues a ruling within 180 days. The plan would go into effect in 2022 and last through 2026. Even if the plan is approved by CMS, however, it will still face an uphill battle.
“If it gets approved, it will definitely be challenged,” Keith said.
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