Laura Colbert, executive director of Georgians for a Healthy Future, agreed the issues of drug prices and transparency, coupled with the role PBMs play in the equation, will come up…
Both of Governor Kemp’s health care proposals were approved by federal health officials in the last two weeks. Unfortunately, both proposals fall short of the bold, evidence-based action that Georgians need their state leaders to take. These plans may impact you or people you know. While some details of the plans are still being sorted out, we have tried to answer some of your early questions here. As we learn more and these plans roll out, GHF will keep you updated with the information you need to get covered, stay covered, and help your loved ones do the same.
Georgia’s Medicaid proposal to begin July 2021, but leaves thousands in the coverage gap
Georgia’s approved Medicaid plan will expand coverage to some low-income, uninsured Georgians.
Who will be affected? Adults with incomes below the poverty line ($12,760 a year for an individual or $26,200 for a family of four) may be able to apply for Medicaid coverage
When? July 1, 2021
How can I/people I know get coverage? In order to enroll and stay enrolled, you will need to prove you are working, attending school, volunteering or doing another government-approved activity for at least 80 hours per month. Some applicants will also need to pay a $7-11 premium in order to start and keep their coverage. GHF will keep you updated with more details about how to apply and what information will be required as we learn more in the coming months.
Is this Medicaid expansion? No. Even when this plan is fully implemented it will only cover a fraction of Georgians who could be covered by full Medicaid expansion, and Georgia is choosing to pay three times more per person that we would under Medicaid expansion.
Can Georgia still expand Medicaid? Yes! Our state leaders have the power to do the right thing and create a pathway to coverage for all Georgians. Tell state leaders that the Governor’s plan falls short and that Georgians need Medicaid expansion instead!
Worrisome changes to Georgia’s private insurance marketplace to begin in 2022
Governor Kemp’s plan to reshape the health insurance market in Georgia will take place in two phases between 2021 and 2022. The first phase is largely positive and will result in lower premiums. The second phase will make it much harder for Georgians to shop for and enroll in affordable, comprehensive coverage.
Who will be affected? Georgians who purchase their health insurance through the ACA marketplace (healthcare.gov)
When? Around November 2021 & October 2022
What changes should I expect?
Part 1: Beginning in November 2021, Georgia consumers will begin shopping for 2022 health insurance plans on healthcare.gov. They will likely notice lower premiums but few other differences.
Part 2: Likely beginning in October 2022, consumers will begin window shopping for 2023 health insurance plans. They will no longer be able to shop at healthcare.gov and will have to find an approved enrollment vendor (insurance agents & brokers, insurance companies, etc.) to shop and enroll. When we know more about how the new “non-marketplace” will work and when it rolls out, GHF will help you understand how to navigate this new system.
Does this impact my current health insurance plan or the health insurance plan that you buy for 2021? No. These proposals do not go into effect immediately. We will let you know when things change and what to expect.
Can I still get affordable, comprehensive health insurance that covers all basic health services? Yes. The ACA still remains the law of the land. (Unfortunately, Georgia’s Attorney General is in court right now trying to strike down the entire law, but we will tell you more about that next week.) Health plans sold on healthcare.gov must cover all 10 essential health benefits and cannot charge more to cover people with pre-existing conditions. When the Governor’s new system takes effect in 2022, it will be harder to tell which plans follow the ACA rules and how your financial help applies to those plans.