ATLANTA – The Georgia state government will operate its own marketplace for individual health insurance for the first time, under legislation that Gov. Brian Kemp signed into law Tuesday.
The Republican governor said during a ceremony at the state Capitol that the law would create a better way for people to “know and compare their health insurance options” and would “bring further competition in the field.”
“Georgians know their needs and those of their families best,” he said.
The law is one of three major changes that could affect hundreds of thousands of Georgians who receive subsidized health insurance through the state and federal governments.
Kemp’s administration also plans to begin a partial expansion of Medicaid in July to cover some working-age adults whose income is below the poverty line but who work or attend school. And like all states, Georgia is reviewing the eligibility of all of its 2.4 Medicaid beneficiaries as a pandemic-era rule that prevented the state from removing beneficiaries ends.
Senate Bill 65, which enabled the state market, went into effect with Kemp’s signature. It repeals an earlier law that prevented the state from setting up its own healthcare exchange. This law was part of an effort to bar Georgia from participating in the Affordable Care Act under then-President Barack Obama. However, the federal government offers health insurance through the Healthcare.gov website, and nearly 900,000 Georgians signed up for individual health insurance during the annual registration period, which ended Jan. 15.
Many Georgians with incomes above the poverty line can purchase the policies at little or no cost because of the federal premium subsidy, although the co-payments can be significant. People with higher incomes can also take out policies on the individual market.
Georgia has not embraced the changes of the Obama era. Kemp continues to oppose a full Medicaid expansion with no work requirements, a move that could bring insurance to hundreds of thousands. But having Insurance Commissioner John King run a marketplace for Georgians mitigates the total contempt Republicans once had for the Affordable Care Act. The state has also spent hundreds of millions to subsidize high-cost claims, a move that comes as premiums in the individual market have been reduced and enticed more insurers to offer coverage outside of the Atlanta metro area.
Insurance Department spokesman Weston Burleson said Georgia authorities hope to open the state marketplace as early as November this year. However, federal officials could push Georgia’s launch date back to 2024. Federal regulations typically require states to spend at least 15 months building their own marketplace.
The state market will be different than what Kemp originally planned. He wanted to put insurance deals in the hands of private brokers who could sell policies with the insurance package required by the Affordable Care Act as well as policies with lower benefits. Those measures might have been cheaper, but Laura Colbert, executive director of Georgians for a Healthy Future, said they would have been worse for consumers.
“That really would have taken Georgia back to the bad old days where insurers really gave consumers a head start and it was incredibly difficult to compare plans,” Colbert said, calling Kemp’s original plan a “non-marketplace.”
President Joe Biden’s administration balked at Kemp’s plan, and after a legal battle, Kemp agreed to a centralized state marketplace that would sell only state-approved policies.
Kemp administration officials say they’re ready to launch the marketplace quickly because they’ve done so much work on the earlier proposal, which they spent at least $31 million on.
A state market could have some benefits, Colbert said. She suggested, for example, that Georgia could extend its enrollment deadline beyond the normal November 15 to January. 15 windows. She also suggested allowing people to get health insurance with their income tax returns and making a one-stop application for Medicaid, Peach Care Insurance for Children, and the state marketplace.
“Some state marketplaces have done some really innovative things. I think it’s not clear yet whether Georgia will get there or not,” Colbert said.
