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Month: October 2023

Changes are coming to the way many Georgians enroll in health insurance.

Here is what you should know. 

Every year on November 1st, the ACA’s health insurance marketplace opens so that Americans who don’t have job-based health insurance or other coverage can shop for and enroll in health insurance. In 2023, 879,084 Georgians enrolled in coverage through the marketplace. This fall Georgians will preview changes to our marketplace shopping and enrollment experience that will go into full effect next year. Here’s what you need to know about those changes.  

“I’ve never had an employer provide health coverage for me,” said Pat, owner of Pat Valley Inc, who lives in Georgia and gets his health coverage through the ACA marketplace. “So this is something that I’ve been dealing with for a long time. It has gotten better since the Affordable Care Act was passed and implemented and has gotten easier with healthcare.gov up and running. I can now [enroll] every year, and I know the process and what (financial help) I will be getting that will help me and that is hugely important.” 

Under the ACA, each state has the option to create its own health insurance marketplace, called a state-based marketplace (SBM), or use the federal marketplace at healthcare.gov. 

Since 2013, Georgians have used healthcare.gov to view plans, qualify for financial help to lower the cost of health insurance, and enroll in the health plan of their choosing. Earlier this year, Georgia lawmakers moved to change that. The state legislature and Governor Kemp passed a new law that allows Georgia to create its own state-based marketplace (SBM). Since then, the Georgia Department of Insurance has been working to create and launch Georgia Access.

What should you know about the change to Georgia Access? 

During this fall’s open enrollment period (Nov. 1, 2023-Jan. 15, 2024), Georgia will operate a hybrid model with the state and federal government working together to manage Georgia’s marketplace. During this hybrid status, you can still use healthcare.gov to shop for and enroll in coverage. 

You may see ads or other promotions about Georgia Access as well. You can visit GeorgiaAccess.gov and become familiar with it. When you click to shop for health coverage or apply for financial assistance, you will be taken to healthcare.gov to complete the process. 

In fall 2024, the state and federal government will transition the marketplace from this hybrid model to Georgia Access. That is when you will begin using GeorgiaAccess.gov to shop and enroll in coverage. (If you visit healthcare.gov after this transition takes place, you will be directed to GeorgiaAccess.gov instead.)

As this change approaches, GHF will share more information about what to expect and how to prepare. Our enrollment assisters are available if you have any questions about how to get covered and stay covered this year and next year: 

  • Angelica Rivera, arivera@healthyfuturega.org, (470) 654-5484. Special focus on LGBTQ+ and Hispanic Georgians. 
  • Deanna Williams, dwilliams@healthyfuturega.org, (470) 654-5509. Special focus on middle Georgia.  

So what is Georgia Access? 

Georgia Access is a state-based marketplace. SBMs are operated by the states, with oversight from federal health officials at the Centers for Medicare and Medicaid Services (CMS). An SBM carries out almost all aspects of operating the health insurance marketplace, including making sure insurance plans meet certain requirements, providing financial assistance, and supporting consumer outreach and assistance. 

SBMs must retain important protections that you have come to expect, like offering only comprehensive plans that follow the ACA’s protections and providing a “one-stop shop” where consumers can view plans, find out about financial assistance, and enroll in coverage. 

SBMs are not better or worse than healthcare.gov. It really depends on how well the state operates its marketplace. SBMs are time- and cost-intensive to set up and maintain with no guarantee of good results. States that effectively run their SBMs can innovate in ways that improve consumers’ shopping and enrollment experience or enhance the quality of insurance plans offered. 

Check out GHF’s SBM fact sheet if you want to learn more! 

The success of Georgia Access will be determined by the work that the Georgia Department of Insurance puts in ahead of its full launch next year. GHF will continue to work with the Department to ensure Georgia Access meets the coverage needs of Georgia individuals and families. 

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