Georgians planning to buy health insurance for next year on the Affordable Care Act’s federal shopping website healthcare.gov will still be able to do that, the Biden administration said this week, as it formally suspended Gov. Brian Kemp’s efforts to block the site.
The Biden administration said in a letter to Kemp’s office Tuesday that it was ”committed to working with Georgia to make changes to (Kemp’s proposal) to ensure enrollment does not decrease in the State under the waiver.”
A spokeswoman for Kemp, Katie Byrd, said the governor’s office is evaluating its options based on the decision. Asked directly whether it would attempt to stop healthcare.gov shopping in Georgia despite the federal decision, Byrd said Kemp’s office would answer that question “in the proper forum.”
“We knew they were going to do this,” Kemp told an AJC reporter Wednesday. “They’ve been throwing roadblocks up and moving the goalposts ever since they got in,” he said, speaking of the Biden administration. “So it’s no surprise to us. We’re just going to let the lawyers handle it.”
A legal expert who has been watching the Georgia battle, Katie Keith, said Georgia might sue. But, she said, “if I was a consumer, I think it’s safe to say the expectation at this point is you will use healthcare.gov for open enrollment this year.” Keith is director of the Health Policy and the Law Initiative at Georgetown University Law Center.
The Kemp administration said recently that it has already spent at least $31 million on its proposal to bar Georgians from shopping for health insurance on the federal healthcare.gov website.
Open enrollment shopping begins on Nov. 1 for coverage that starts Jan. 1, 2023.
In issuing its letter Tuesday, the Biden administration said it would continue to work with Georgia to see if Georgia’s plan could be implemented for 2024 or after. The Biden administration said that said it expressed misgivings on the same issues for more than a year and had still not received an action plan from Georgia to address those issues. Questions included how the state would work with state residents who might need assistance buying insurance outside of the healthcare.gov website.
Kemp’s proposal had been approved by the outgoing administration of former President Trump. Under the Affordable Care Act, states may obtain a “waiver” from the federal government to tailor some ACA provisions in ways that would better fit the state. But the Biden administration argued that the pandemic raised questions about whether the Georgia waiver would actually decrease the number of people enrolled rather than increase it as it was supposed to do.
Georgians can already shop for ACA plans from independent brokers, but most use the federal website instead, where they can compare different companies’ plans in one place. About 700,000 Georgians are on ACA plans, most purchased via healthcare.gov.
Kemp aides argued that Georgians would find it easier to shop for insurance from private companies, because they are more motivated to be consumer-friendly. Private-sector brokers would be more motivated to make the experience easy, Kemp’s office argues.
Patient advocates argue that private sector brokers have a record of prioritizing their own profit, and selling plans that may not best meet customers’ needs.
It’s unclear exactly what web functions the state has developed to refer Georgians to private insurance companies. In addressing the $31 million spent on the proposal so far, a spokesman for Kemp said only that it went to “technical system needs and digital architecture services, consulting and project management services, a public awareness campaign, and general program consulting support.”
Kemp’s office has not described exactly what rerouting the website would look like. But so far Kemp’s aides have not said they’re building a state-based exchange as the Affordable Care Act allows.
State-based exchanges under the ACA, like those in Idaho or Kentucky, replace the federal shopping site healthcare.gov by building a state website that also allows comparison shopping. State-based exchanges also must follow federal requirements, such as providing assistance to underserved communities and helping ensure that premiums overall stay lower by selling robust insurance to healthy people as well as unhealthy people.
AJC reporter Greg Bluestein contributed to this story.
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