Healthcare.gov to be Eliminated in Georgia: What Does This Mean for ACA Coverage?

A significant change is coming to the way Georgians access health insurance through the Affordable Care Act (ACA). The state has been granted a 1332 state innovation waiver by the Centers for Medicare & Medicaid Services (CMS), which will allow it to overhaul its Medicaid program and remove the healthcare.gov portal. This move has sparked both praise and criticism, with supporters arguing that it will lower healthcare costs and provide more choice in plans, while critics worry that it will lead to lower coverage and confusion among consumers.

What is the 1332 State Innovation Waiver?

The 1332 State Innovation Waiver is a provision in the ACA that allows states to request permission from CMS to implement innovative changes to their Medicaid programs. These changes can include expanding or reducing eligibility, altering the way benefits are delivered, or implementing new financing mechanisms.

Georgia’s waiver proposal includes several key changes, including:

Eliminating the healthcare.gov portal: Starting in 2023, Georgians will no longer be able to purchase ACA health plans through the federal marketplace. Instead, they will have to purchase plans directly through insurance websites or web brokers.
Incentivizing health insurers to participate in the exchange: CMS will offer protection against catastrophically high claims to health insurers that participate in the state-run exchange.
Implementing work requirements for certain Medicaid beneficiaries: Able-bodied adults who are not pregnant, disabled, or caring for a child under 6 years old will be required to work or participate in job training in order to qualify for Medicaid coverage.

Arguments in Favor of the Waiver

Georgia has the highest uninsured rate in the country, at 13.7%. Proponents of the waiver argue that it will lower health care costs in the state and provide more choice in plans for Georgians. They also believe that the work requirements will encourage able-bodied adults to become self-sufficient.

Arguments Against the Waiver

Opponents of the waiver worry that the shift from healthcare.gov could confuse people, leading to lower coverage. They also argue that the work requirements will make it harder for low-income adults to access health insurance.

What’s Next?

The Georgia waiver is still in the early stages of implementation. It is unclear how the changes will affect coverage and costs in the state. The waiver will be closely monitored by CMS and other stakeholders to assess its impact on the ACA.

Conclusion:

If you live in Georgia and are currently enrolled in an ACA health plan through healthcare.gov, you will need to take steps to purchase a plan directly through an insurance website or web broker starting in 2023. It is important to compare plans and costs to find the best option for your needs. If you are eligible for Medicaid, you may be affected by the work requirements. It is important to contact your local Medicaid office for more information.