1. Home
  2. >
  3. affordable care act

Tag: affordable care act

New federal fix expands the number of Georgia families who qualify for affordable health coverage

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.

(more…)

Tags:

GHF participates in visit from U.S. Department of Health and Human Services Secretary Becerra

By: Knetta Adkins

A group of adults standing together wearing masks in front of a sign at Southside Medical Center. They are a mix of Black, White, Latino, and other races.
HHS Secretary Xavier Becerra at Southside Medical Center, Atlanta, GA.

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. 

(more…)

Tags:

The ACA remains the law of the land!

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.

(more…)

Tags:

CMS Requests More Information about Georgia’s Proposed Changes to Private Insurance

New Public Comment Period Expected in July

On June 3rd, 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!



Tags:

Governor Kemp’s health care plans approved: What do they mean and what’s next

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.

(more…)

Tags:

New! Getting Georgia Covered 2020

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.


Tags:

Sign up for 2021 health coverage before Dec. 15th!

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:


Tags:

GHF submits comment to federal government about Governor’s revised private insurance proposal

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.


Tags:

GHF comments on Governor’s revised private insurance proposal

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.


Tags:

Health insurance options for Georgians during COVID-19

Line of diverse workers with umbrellas symbolizing health insurance

More than 1 million Georgians have lost their health coverage due to job loss during the COVID-19 pandemic. If this is your situation, you can keep yourself and your family covered during this health crisis.

You have three main pathways to coverage:

  1. Affordable Care Act
    • With financial assistance—half of Georgians who lose their insurance will qualify for ACA coverage with financial help to lower the premium they pay each month. In some cases, you may see lower deductibles & co-pays too.
    • Without financial assistance—some Georgians, despite a job loss, will still make too much for financial help but you should still shop for coverage to see if there’s a plan that fits your new budget.
  2. Medicaid & PeachCare for Kids—About 25% of Georgians losing their health coverage may qualify for Medicaid. Georgians most likely to qualify for Medicaid coverage include children, low-income pregnant women, and very low-income parents. Other Georgians who qualify for Medicaid are people with disabilities, seniors, and low-income women with breast or cervical cancer.
  3. COBRA—in most cases, you will be able to find less expensive coverage from the ACA marketplace. COBRA may be the best option for you if it is important that you maintain a consistent provider (pregnant women, people with chronic or complex conditions).

Some Georgians who have lost their health coverage due to job loss will fall in Georgia’s coverage gap because the state has not expanded Medicaid. That means they can’t get financial help through the ACA and they also don’t qualify for Medicaid.

If you are in the coverage gap because you lost your job, please read the If you are uninsured section (click to go directly there). Then contact Georgians for a Healthy Future at 404-567-5016 x 4 to learn how you can share your story and help fix the problem!


Affordable Care Act (ACA) coverage

You may be eligible for a Special Enrollment Period up to 60 days after losing your job-based health insurance. You only qualify for coverage for 60 days after you lose your health coverage, so shop and enroll as soon as possible. Visit healthcare.gov to shop and enroll.

Financial assistance is available!

When you begin the shopping/enrollment process, healthcare.gov will ask you about your estimated income for 2020. With that information healthcare.gov will let you know if you qualify for financial help to lower your premiums and other costs. Most Georgians qualify for financial help!

When you estimate your income, include the money you made from your job before you were laid off, any unemployment checks that you expect to receive, and any money that you expect to make from getting re-hired/a new job later in the year. Do not count your stimulus check as income!

Table that is titled "You are likely to qualify for financial help if your income falls in these ranges".

For free help with the enrollment process, contact Insure Georgia at insurega.org or 866-988-8246.

Coverage through the ACA marketplace covers testing for COVID-19. It will also cover part or all of the costs related to COVID-19 treatment. Contact your insurance company for more information.


Medicaid & PeachCare for Kids

You can enroll yourself, your family, or your children in Medicaid or PeachCare for Kids at any time, if you qualify. Enroll at gateway.ga.gov.

Cartoon mom and child standing together

Children are most likely to quality for Medicaid and PeachCare. Pregnant women and some parents may be eligible for Medicaid coverage depending on your monthly income. (The amount of unemployment you get from Georgia counts as income but the additional $600 per week from the federal government does not.)

Click here to see if you can qualify as a parent and to see if your kids qualify. If you are pregnant, you must make less than these amounts to qualify for Medicaid:

Medicaid is required to cover COVID-19 testing and treatment for free. In addition, you do not have to pay any Medicaid or PeachCare premiums or co-pays during the COVID-19 national emergency.

If you have or enroll in Medicaid coverage, you cannot be disenrolled (kicked off) during the COVID-19 national emergency.

If you have questions about Medicaid and whether you qualify, call the Georgia Division for Family & Children Services at 877-423-4746.

You may also contact Atlanta Legal Aid (find the phone number for your county here) or Georgia Legal Services Program at 1-800-498-9469 with questions or concerns.


If you are uninsured/unable to get health coverage

Do not skip or avoid health care just because you are uninsured! You can get free or low-cost health services at:


References & resources

COVID-19 Town Hall PowerPoint slides by Center on Budget & Policy Priorities
Frequently Asked Questions by Center on Budget & Policy Priorities


Tags:

Stay Connected

Sign up to receive updates from GHF!
Join

GHF In The News

Jan 25, 2023
Georgia to reinstate eligibility verifications for Medicaid and PeachCare for Kids members
Jamarlo Phillips and Rachel Aragon

“They haven’t done any checks since March of 2020 so everyone has been able to keep their coverage for that entire period without having to renew,” said Laura Colbert, Executive…

Archive