The Biden administration has officially suspended Gov. Brian Kemp’s plan to block Georgians from shopping for health insurance coverage on the Affordable Care Act marketplace later this year.
Open enrollment for ACA plans typically begins Nov. 1. More than 400,000 Georgians use the marketplace to sign up for their insurance. Currently, 700,000 Georgians are covered by ACA plans and the majority buy them on the website healthcare.gov.
Under the Kemp plan, when shoppers went to the website to shop for plans, it would have instead directed them to buy their plans from individual insurance companies or private brokers. President Trump’s administration approved the plan, called a “waiver,” shortly before he left office.
Kemp’s team had argued that private insurance companies and agents would do a better job of matching shoppers to plans.
Opponents of the plan had argued that private companies do a poor job explaining pitfalls in plans and comparing their competitors’ options. Their studies showed some shoppers would walk away with inadequate coverage or drop coverage altogether.
Friday’s decision by the Biden administration will have no immediate effect on people who have bought insurance through the open marketplace exchange.
Federal regulators said Kemp’s planned changes in the marketplace could breach federal rules around insurance waivers and cause too many people to be dropped from coverage.
The letter from the U.S. Centers for Medicare and Medicaid Services, or CMS, gives Georgia until July 28, 2022, to formulate a “corrective action plan ... ensuring that the waiver will provide coverage to a comparable number of residents, that the coverage will be at least as comprehensive and affordable as coverage provided without the waiver, and that the waiver will not increase the federal deficit.”
A spokeswoman for Kemp said Friday his office is reviewing the Biden administration’s decision. Georgia’s previous letters to CMS have said Kemp’s plan will better meet the needs of Georgia’s currently underserved populations.
An opponent of the Kemp plan, Georgians for a Healthy Future director Laura Colbert, said the suspension was warranted.
“Any plan that would meaningfully disrupt health insurance for 700,000 folks should be carefully considered,” Colbert said in an emailed statement.
“Georgia leaders have refused to answer questions about their plan to separate from healthcare.gov, and disregarded evidence that their plan will mean some hard-working Georgians lose their coverage.”
The Biden administration and the Kemp administration have been in tense correspondence about Kemp’s health care “waiver” plans for months. They’re called waivers because the federal government agrees to waive part of federal law in order to allow a state to tailor the ACA program or Medicaid program to the state’s needs.
The Trump administration agreed with the Kemp administration on the ideas behind all their waivers, and worked for years to develop plans that pushed the waiver powers to new lengths, but that might still pass judicial muster. They finished them near the very end of Trump’s term.
One of Kemp’s waiver plans that the Biden administration has agreed with puts state money directly into insurance coffers, lowering the cost of ACA plans, especially in rural areas. It’s already in effect.
The plan to block ACA shopping on healthcare.gov was one of two Kemp proposals that may well be decided in the courts. The other is Kemp’s plan to expand Medicaid to the poor but only if they meet a work requirement.
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