ATLANTA — Gov. Brian Kemp signed a bill into law on Tuesday that will pave the way for Georgia to establish its own state exchange under the Affordable Care Act.
The bill, SB 65, directs the Georgia Commissioner of Insurance to "establish any advisory board or committee the Commissioner deems necessary for providing recommendations on the creation, implementation or operation of an exchange."
The law comes as a reversal of sorts for Georgia, which at one point sought to create its own private healthcare marketplace outside the architecture of the ACA. It had received a waiver from the Trump administration to go ahead with that plan, but the Biden administration revoked it last year.
Whitney Griggs, a health policy analyst with Georgians for a Healthy Future, said the move helps the state avoid paying billions of dollars per year in fees to use healthcare.gov.
"A state using a state-based marketplace can customize their outreach methods, their outreach documents, their navigator programs to meet the state's needs rather than using generalized materials and documents," Griggs said. "The state has realized they can save money on the user fees and repurpose that money for its customized outreach and resources to really make it Georgia-specific.”
Several states run their own exchanges under the umbrella of the ACA, among them California and New York. Griggs said the rollouts had been mostly successful, but noted a history of several people being dropped from their health insurance coverage when transitions occurred. Georgia would still need approval from the Biden administration to join that group.
According to the Centers for Medicare & Medicaid Services, more than 879,000 people in Georgia signed up for health insurance through the federal healthcare.gov insurance exchange for 2023. That number includes Cindy Pursley, a recently retired accountant who lives in Newnan. She said she worries about possibly being kicked off her coverage once the state-run online healthcare marketplace goes live.
"Insurance was an issue, and I’m a three-time cancer survivor with a genetic mutation, which makes pre-existing conditions and all sorts of things," Pursley said. "I was concerned I wouldn’t be able to find an ACA plan on there or I might pick the wrong one by accident.”
In a statement, the Georgia Budget and Policy Institute called on the state to delay implementing a state exchange until the recently-begun Medicaid unwinding process is complete, saying the launching of an exchange and the management of the unwinding process at the same time could "create unnecessary risks that could be burdensome for state employees."
The unwinding process will continue through May 2024. It is a review of the eligibility of the 2.7 million residents on Medicaid, whose status with the program was protected by the federal government's COVID-19 public health emergency until it ended last month.
“Moving to a state-based exchange is not a cost-saving measure for the state, Griggs said. "We are going to save money on the user fee, but the intention is that the money is then turned around into technical support, making the system operate for the needs of Georgians, for outreach and enrollment. We want to ensure that we’re keeping Georgians covered, that they’re able to get the good quality insurance they’re used to and we don’t lose trust in the process.”
SB 65 was among several healthcare-related bills signed by Gov. Kemp on Tuesday.
(The video below is from when Gov. Kemp announced his healthcare reform proposals in 2020.)