ATLANTA (AP) — The Trump administration has approved Georgia’s plan to overhaul how state residents buy health insurance under the Affordable Care Act.
The Centers for Medicare & Medicaid Services announced that federal officials on Sunday signed off on Gov. Brian Kemp’s proposal to offer federally subsidized health insurance through private brokers instead of the HealthCare.gov website. The move was expected after CMS Administrator Seema Verma said during a visit to the state last month that approval was imminent.
“Today’s approval of the state’s waiver will usher in a groundswell of healthcare innovation that will deliver lower costs, better care, and more choice to Georgians in the individual market,” Verma said in a statement.
Georgia would be the first state where residents would buy insurance directly from brokers or insurers on sites where they would be able to compare plans that meet the requirements of the ACA — President Barack Obama’s signature health law — with those that don’t.
Kemp’s administration says private brokers or websites will provide better service and offer more options that will boost insurance coverage.
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.
Passed in 2010, the ACA extended insurance coverage to millions of Americans by expanding Medicaid and subsidizing premiums for individuals and families who make up to four times the federal poverty level. Georgia has separately received permission for a limited Medicaid expansion.
The move away from Healthcare.gov would occur in 2023. A year before that, the state would implement another part of its ACA plan that would pay a portion of insurance companies’ costs to treat their sickest patients, a relatively small group that incurs the biggest bills.
The so-called reinsurance program would allow the companies to lower monthly premiums for all customers, a particular benefit for those who don’t qualify for federal subsidies to cover premiums.
But the state will need to contribute an estimated $92 million for that program in its first year — money that has yet to be approved.
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