Biden administration puts brakes on Georgia’s plan to ditch healthcare.gov

The Biden administration is sending a key component of Gov. Brian Kemp’s health-insurance reform plan back to the drawing board.

The U.S. Department of Health and Human Services (HHS) is directing the state to revisit the data supporting a waiver Georgia is seeking from the Affordable Care Act that would substitute a private-sector alternative to the federal government’s healthcare.gov insurance exchange.

The waiver won approval from then-President Donald Trump’s HHS last November. But in a letter to Kemp dated Thursday, Chiquita Brooks-LaSure, administrator of HHS’ Center for Medicare and Medicaid Services (CMS), pointed to changes in both policy and federal law that have altered the landscape.

Among other things, the American Rescue Plan Congress passed in March will strengthen the Affordable Care Act by expanding access to health insurance coverage and lowering the costs of health care, she wrote.

The letter set a deadline of July 3 for Georgia to submit an updated waiver plan reflecting the various changes the Biden administration and Congress have made.

In announcing last October his plan to scrap healthcare.gov in Georgia, Kemp criticized the government-run website as cumbersome and responsible for a 22% enrollment decrease since 2016.

“For me, healthcare.gov is a four-letter word,” the governor said at the time. “The enrollment process has been nothing short of disappointing.”

But Brooks-LaSure wrote that Georgia’s waiver application pointed to a significant need for health coverage in the state despite the enrollment drop. Specifically, she cited an unsubsidized enrollment rate decrease of 72% between 2016 and 2019 and Georgia’s 13.4% uninsured rate, one of the nation’s highest.

Brooks-LaSure expressed a lack of confidence that Georgia’s private-sector approach would get better results than the federal exchange.

“Georgia neither quantified the size of the expected investment by the private sector nor indicated any specific commitments by the private sector to engage in outreach and marketing,” she wrote. “It is unclear if the private market’s outreach efforts in Georgia … would be comparable to [the federal exchange’s] investments.”

Laura Harker, health policy analyst for the Georgia Budget and Policy Institute, praised the CMS letter.

“The state’s proposal for taking away the most popular option for selecting a health care plan – healthcare.gov – could exacerbate our state’s already high rates of uninsured Georgians and inadequate health-care infrastructure,” she said. “This letter from CMS is a step in the right direction to ensure no one loses access to care.”

When asked for comment Friday, Kemp spokesman Cody Hall wrote in an email that the governor’s office is still reviewing the letter.

The waiver from using healthcare.gov is one of two the state has been seeking from the feds. The other waiver, which seeks a more limited expansion of Medicaid than provided for in the Affordable Care Act, was also approved by the Trump administration but was put back on hold after Biden took office.

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