- Georgia Gov. Brian Kemp unveiled an ambitious remaking of the state's individual health insurance market under the Affordable Care Act on Thursday.
- The Republican governor is proposing some $300 million in reinsurance for health plans, but would also shift $2.7 billion in premium subsidies from federal to state control.
- It would also bypass Healthcare.gov and move consumers to the websites of private brokers and insurers – where plans would be marketed as non-ACA compliant coverage.
Kemp said he has applied for a waiver from the Trump administration to implement the plan. He expressed confidence that it would be approved. If so, the policy changes would apply next year and impact individual health plan enrollment in 2021.
After Republicans failed to repeal the law in Congress, the administration has been encouraging states to apply for waivers to upend the ACA as implemented under President Barack Obama. Officials have called it a failed law and complained about high premiums for some.
"The insurance premiums are too dang high," Kemp said at a press conference Thursday proposing the sweeping remake of the state's individual health insurance market. However, his way of addressing the issue has veered far from the intent of the Affordable Care Act.
Kemp has proposed setting aside more than $300 million in public funds to pay to carriers as a form of reinsurance to insulate them from high-cost claims. About a third of the sum would come from the state, with the rest from the federal government.
That could cut individual health insurance premiums by as much as $282 in instances where individuals are paying more than $1,000 a month, Kemp claimed, according to the Associated Press.
He did not propose extending premium tax credits to households that earn above 400% of the federal poverty level, which California is currently doing during open enrollment for its state health insurance exchange. About 90% of Georgians currently qualify for the subsidies, which cut out after household income tops $103,000 for a family of four, according to the Atlanta Journal-Constitution.
Instead, Kemp has proposed that the about $2.7 billion in federal premium tax subsidies used by Georgians to buy insurance be controlled directly by the state instead of being allotted to people who apply for insurance coverage through the Healthcare.gov exchange. Healthcare.gov would also be eliminated.
But instead of building its own exchange, Georgians seeking individual coverage would be steered to private brokerage firms or the insurance companies themselves. And the premium tax credits could be used to buy short-term plans or other forms of coverage that are not compliant with the ACA.
The plan to earmark premium subsidies to pay for plans without ACA protections would "further destabilize the market," Laura Harker, a senior policy analyst at the Georgia Budget & Policy Institute, told the AP.
Georgia is one of 14 states — mostly in the South — that has declined to expand Medicaid eligibility under the ACA. Kemp's administration intends to roll out its Medicaid reform plans next week, officials said.