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Georgia pushes back on reevaluation of health plan

July 10, 2021 GMT
In this July 7, 2021, photo Georgia Gov. Brian Kemp speaks during an interview at his campaign office in Atlanta. Kemp’s office says it was surprised to hear federal officials were reevaluating its plan to overhaul how state residents buy health insurance under the Affordable Care Act. The director of Kemp’s Office of Health Strategy and Coordination said in a recent letter that the move by the Biden administration suggests it wants to revisit the plan's approval, which he said is not allowed. (AP Photo/John Bazemore)
In this July 7, 2021, photo Georgia Gov. Brian Kemp speaks during an interview at his campaign office in Atlanta. Kemp’s office says it was surprised to hear federal officials were reevaluating its plan to overhaul how state residents buy health insurance under the Affordable Care Act. The director of Kemp’s Office of Health Strategy and Coordination said in a recent letter that the move by the Biden administration suggests it wants to revisit the plan's approval, which he said is not allowed. (AP Photo/John Bazemore)

ATLANTA (AP) — The Biden administration’s decision to reevaluate Georgia’s plan to overhaul how state residents buy health insurance under the Affordable Care Act came as a “surprise” and suggests it wants to revisit the plan’s approval, which is not allowed, Gov. Brian Kemp’s office said.

Georgia’s plan — dubbed “Georgia Access” — would improve the experience of shopping for insurance and encourage the private sector to enroll uninsured Georgia residents, the director of Kemp’s Office of Health Strategy and Coordination said in a letter to the federal Centers for Medicare and Medicaid Services.

“Despite unsubstantiated claims to the contrary, Georgia Access will put more affordable, quality insurance coverage within reach of consumers in our state than a one-size-fits-all federal solution,” the letter by Grant Thomas says. It is dated July 2 and was first reported by Georgia Health News.

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Under the Republican governor’s plan, Georgia residents would bypass healthcare.gov and shop for federally subsidized health insurance through private agents.

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.

Former President Donald Trump’s administration approved the state’s plan last year, and state officials have touted it as a way to boost insurance coverage. Democrat Joe Biden’s administration has sought to bolster the ACA — President Barack Obama’s signature health care law.

In a letter last month to Kemp, the U.S. Department of Health and Human Services raised concerns about the proposal to have the private sector, not the government, engage in outreach to get state residents to sign up for insurance under the ACA. Georgia had not indicated any specific financial commitment by the private sector to engage in marketing, federal health officials said.

The letter, signed by Chiquita Brooks LaSure, head of the Centers for Medicare and Medicaid Services, noted that the Biden administration has increased funding to market the ACA and expanded subsidies and eligibility for tax credits to buy insurance through the program. It asked Georgia officials to factor those changes into updated “actuarial and economic analyses” to see whether their plan would meet federal requirements, including covering a comparable number of people and providing comprehensive benefits.

In his letter, Thomas said 11 insurance carriers, including five new ones, and eight enrollment vendors have committed to participating in Georgia Access. The state has already made “substantial” investments in its plan on top of investments by private groups. The letter asks for clarification on the Biden administration’s request, including how it meets the terms and conditions of the Trump administration’s approval. Those terms, Thomas said, do not allow federal officials to “reopen the approval” of the plan.