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Will Washington Roll Back Georgia’s Coverage Gains?

What the House Budget Bill Could Mean for Georgia Access

Background

On May 22, the U.S. House passed a sweeping budget bill, known as the “One Big Beautiful Bill” Act. The budget bill proposes significant changes to the Affordable Care Act (ACA) Health Insurance Marketplace, which is known as Georgia Access in our state. Proponents say these changes will cut costs, but they would also make it harder for many Georgians to enroll in or keep their health coverage.

The Senate is now making its changes to the bill, but what those changes will look like is unclear. As currently written, projections from the non-partisan Congressional Budget Office (CBO) show the House’s changes would reduce overall Marketplace enrollment and increase the uninsured rate nationally and in Georgia. If the budget bill passes as currently written, the combination of Marketplace (including allowing the expiration of the enhanced premium tax credits) and Medicaid changes could lead to an estimated 560,000-940,000 Georgians becoming uninsured.[1] (Notably, some of the marketplace changes presently in the bill are also under consideration by the Centers for Medicare & Medicaid Services (CMS), meaning they could be authorized through federal regulation even without new legislation.)

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GHF comments on Governor’s proposed reinsurance program

On December 23, 2019, the Georgia Department of Community Health (DCH) submitted Governor Kemp’s 1332 private insurance proposal to federal health officials.

The plan consists of two parts:

  1. A reinsurance program to lower premiums; and
  2. A dramatic erosion of the ACA’s rules and structures, including provisions that privatize insurance enrollment; cap the financial assistance available to low- and middle-income consumers; and erode consumer protections in private insurance

DCH’s submission of the proposal to the Centers for Medicare & Medicaid Services (CMS) comes after a 30-day public comment period, during nearly 1000 Georgians weighed in with their opinions on the plan. Despite the overwhelming opposition to the second part of his plan, Governor Kemp and DCH sent the proposal to federal officials with no meaningful changes.

On February 5, 2020, Governor Kemp wrote a letter to requesting that the reinsurance program be considered separately from the second part of his proposal, and that CMS’s consideration of the second part of the plan be paused. CMS responded to Governor Kemp on February 6 in a letter that deemed the reinsurance program application complete and requested more information about the remaining parts of the Governor’s proposal.

CMS’s response began a 30-day public comment period on the proposed reinsurance program, allowing Georgians, health advocates, and any other interested party to weigh in.

GHF, along with several partner organizations, submitted a comment communicating our support of the reinsurance program, while noting our deep concerns about the remainder of the Governor’s proposal. You can read the full comment letter here.

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