Feds block Georgia’s plan to have private sector handle ACA

ATLANTA (AP) — President Joe Biden’s administration on Friday halted Gov. Brian Kemp’s plan to have the private sector, not the government, engage in outreach to get state residents to sign up for insurance under the Affordable Care Act.

Kemp, a Republican, had planned to bypass healthcare.gov and have residents shop for federally subsidized health insurance through private agents. Former President Donald Trump’s administration approved that plan in 2020, and state officials had touted it as a way to boost insurance coverage.

But federal regulators said Kemp’s planned changes in the marketplace could breach federal rules around insurance waivers and cause too many people to be dropped from coverage, The Atlanta Journal-Constitution reported.

The letter from the U.S. Centers for Medicare and Medicaid Services gives Georgia until July 28 to formulate a “corrective action plan … ensuring that the waiver will provide coverage to a comparable number of residents, that the coverage will be at least as comprehensive and affordable as coverage provided without the waiver, and that the waiver will not increase the federal deficit.”

A spokesperson for Kemp told the newspaper his office is reviewing the decision.

Friday’s decision by the Biden administration will have no immediate effect on people who have bought insurance through the open marketplace exchange.

The governor’s office has said private websites would provide better service and offer more options that will increase insurance coverage in the state.

But critics worry the move will make it harder to shop for insurance and drive healthy people to cheaper plans that provide limited coverage, increasing insurance premiums for older and sicker people who need the comprehensive benefits required by the ACA. That’s because Georgia’s move to private websites would make it easier for consumers to simultaneously see plans that don’t provide all the benefits required by the ACA.

An opponent of the Kemp plan, Georgians for a Healthy Future director Laura Colbert, said the suspension was warranted.

“Any plan that would meaningfully disrupt health insurance for 700,000 folks should be carefully considered,” Colbert said in an emailed statement to The Atlanta Journal-Constitution.

“Georgia leaders have refused to answer questions about their plan to separate from healthcare.gov, and disregarded evidence that their plan will mean some hard-working Georgians lose their coverage.”

The plan to block ACA shopping on healthcare.gov was one of two Kemp proposals that could be decided in the courts. The other is Kemp’s plan to expand Medicaid to the poor but only if they meet a work requirement. The Biden administration has already blocked that proposal, a move that Georgia has sued over.