Thanks to a move by the Biden administration, 206,000 more Georgia families will qualify for financial help to purchase health insurance under the Affordable Care Act (also called Obamacare). The “family glitch” has plagued working families whose jobs offer affordable coverage for the worker but not for their family members. With the new federal fix, the family glitch will no longer stand between Georgia’s working families and the affordable health coverage and care they deserve.

By: Knetta Adkins

On August 2nd, I had the opportunity to meet with Secretary Xavier Becerra, the 25th Secretary of the Department of Health and Human Services. During his August trip to Georgia, Secretary Becerra hosted a roundtable with community leaders to hear about the health care concerns and challenges most affecting Georgians. Congresswomen Carolyn Bordeaux, Lucy McBath, and Nikema Williams, state Representative Matthew Wilson, and Mayor Keisha Lance Bottoms participated in the roundtable, as well as representatives from Community Catalyst, Protect Our Care Georgia, and others. It was an exciting moment to represent Georgians for a Healthy Future and share on behalf of the marginalized Georgians for whom we advocate. 

Georgia consumers relieved of threat to health coverage by U.S. Supreme Court’s third affirmation that Affordable Care Act is lawful

With the ACA firmly in place as the law of the land, federal and state law makers should turn their attention to improving affordability and closing remaining coverage gaps

Statement by Whitney Griggs, Health Policy Analyst at Georgians for a Healthy Future regarding today’s ruling on the California v. Texas lawsuit by the Supreme Court of the United States. The lawsuit sought to invalidate the Patient Protection and Affordable Care Act; Georgia was a plaintiff in the case.

On June 3^rd, 2021, the Centers for Medicaid and Medicare Services (CMS) sent a letter to Governor Kemp requesting additional data on the potential impacts of the Georgia Access Model. The Georgia Access Model was put forward by Kemp in his 1332 private insurance waiver, and the model would end access to healthcare.gov for Georgia consumers.

CMS is requesting additional data from the state because they believe recent changes made by President Biden’s administration to the Affordable Care Act’s health insurance marketplace have made the state’s previous analysis outdated or inaccurate. The Biden administration’s changes include:  

• The COVID Special Enrollment Period (SEP)—through August 15, 2021, almost any American who does not have health insurance through their job can enroll in health coverage at healthcare.gov or by phone at 1-800-318-2596;
• More generous and expanded eligibility for Premium Tax Credits (PTCs)—almost anyone who qualifies for coverage through the ACA is now eligible for a discount on their monthly premium; and
• Increased funding for outreach and marketing for the ACA marketplace and enrollment opportunities.

These actions have led to more Americans, and Georgians, enrolling in Marketplace coverage. In addition, CMS believes that ACA enrollment would likely remain higher through 2023, when the Georgia Access Model is slated to begin.

In the letter, CMS also reasons the increase in enrollment could change insurance market dynamics enough to reduce the private sector’s incentive to enroll consumers. CMS believes with fewer uninsured people to enroll, the private sector may be less motivated to reach uninsured individuals. The idea that the private sector will be incentivized to enroll consumers once the competition of healthcare.gov is gone is a crucial assumption of Kemp’s waiver.

Georgia must now respond with updated data that takes into account the new federal changes. The new data will allow CMS to ensure the Georgia Access Model meets the protections specified in Section 1332 of the Affordable Care Act. These protections are:

1. Coverage must be at least as comprehensive as Marketplace coverage;
2. Coverage and protections against high costs must be as affordable as Marketplace coverage;
3. A similar number of people must have coverage under the waiver as without it; and
4. The waiver can’t add to the federal deficit.

The state may also request to adjust the Georgia Access Model, as needed, to meet waiver requirements in light of the new federal policies.

Once Georgia submits the new data about the Georgia Access Model, Georgia consumers, health advocates, and other stakeholders will have a chance to comment on the proposal again. CMS announced in their letter that they will hold a 30-day comment period after they receive Georgia’s new data. GHF expects the comment period will begin in early July. We will be working with our Cover Georgia partners to help Georgia individuals, organizations, and advocates comment. Stay tuned for your opportunity to weigh in again!

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.

Despite repeated claims otherwise, Georgia’s health insurance marketplace has proven to be resilient for consumers in our state. GHF examined the data about Georgia’s 2020 marketplace for our annual Getting Georgia Covered report. We found rising enrollment, lower premiums, and increased choices for consumers. This annual release tells the story of how Georgia individuals and families are faring in the health insurance marketplace. Explore the new interactive digital report to find out more about Georgia’s 2020 marketplace, how it differed from previous years, the Georgians who enrolled and costs of plans, and policy opportunities to increase enrollment, ensure access to care, address affordability, and protect consumers.

Healthcare.gov is open for business from November 1 to December 15, 2020. Georgians can now shop for comprehensive, affordable health plans and enroll in coverage. Nine out of 10 Georgians qualify for financial help to lower their premiums and other costs! Make sure that you are covered in 2021!

Most Georgians who qualify for health insurance & financial help through the Affordable Care Act (also called “Obamacare”) are still uninsured. If you or people you know need more information about how health insurance works, how to enroll in coverage, or what to do after you have signed up, we have you covered! Check out and share these tools so you and your networks can get covered and stay covered:

• Frequently Asked Questions about health insurance
• My Health Insurance User’s Manual
  Available in English and Spanish
• My Health Resource Guide
• Get Covered. Stay Covered. video series

On July 9, 2020, Georgia’s Governor announced that his administration had revised his 1332 private insurance proposal. The new proposal consists of two parts:

1. A reinsurance program to lower premiums; and
2. The Georgia Access model—which would separate Georgia from healthcare.gov but would not replace it, instead directing consumers to insurers and web brokers to shop and enroll in coverage.

After a 15-day public comment period during which more than 600 comments were received from the public, Georgia’s Department of Community Health made no changes and submitted the proposal to the Centers for Medicare and Medicaid Services (CMS) for their review on July 31.

CMS deemed the waiver application complete on August 17. The designation began a 30-day public comment period, allowing Georgians, health advocates, and any other interested party to weigh in on the revised proposal. Because of technical difficulties with the comment submission link, the comment period was extended another seven days to September 23, 2020.

More than 1800 individuals and organizations commented during this time, including GHF. You can read GHF’s full comment letter here.

On July 9, 2020, Georgia’s Governor announced that the state was re-opening the public comment period on his 1332 private insurance proposal. The proposal was considerably revised since it was last considered in February of this year. The new plan still consists of two parts:

1. A reinsurance program to lower premiums; and
2. The Georgia Access model—which would separate Georgia from healthcare.gov but would not replace it, instead directing consumers to insurers and web brokers to shop and enroll in coverage.

Other provisions of the previously proposed Georgia Access model were dropped (cap on financial assistance, new kinds of health plans, etc.).

The Governor’s announcement began a 15-day public comment period on the new proposal, allowing Georgians, health advocates, and other interested parties to weigh in. Along with more than 600 others, GHF submitted comments to communicating our deep concerns about the plan’s continued shortcomings. You can read GHF’s full comments here.