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What Gov. Brian Kemp seeks in federal waiver under Affordable Care Act
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Gov. Brian Kemp arrives at the Ramsey Conference Center at Lanier Technical College Thursday, Sept. 26, 2019, to be the speaker at the Greater Hall Chamber of Commerce board meeting. - photo by Scott Rogers

Gov. Brian Kemp rolled out a plan Thursday that aims to reduce premiums for residents who buy health insurance under the Affordable Care Act.

The plan, known as Georgia Access, could eventually provide subsidies for cheaper coverage that doesn't have to include all of the benefits required by the health law.

“I believe it’s going to give relief to some folks and give some options people don’t currently have,” said State Sen. Butch Miller, R-Gainesville, who stood near Kemp at the Oct. 31 announcement at the State Capitol. “We’ll see.”

Kemp’s plan, a waiver request under the Affordable Care Act, does not address Medicaid coverage. The governor is expected to release its plans for Medicaid next week.

The ACA proposal calls for the state and federal government to pay a portion of insurance companies’ costs to treat their sickest patients, a relatively small group that incurs the biggest bills. The so-called reinsurance program would allow the companies to lower monthly premiums for all customers.

The reduction could be as much as $282 in areas of Georgia where premiums now exceed $1,000, according to estimates from the governor’s office.

Under a second part of the governor’s plan, Georgians could bypass Healthcare.gov and sign up for insurance directly through an insurance provider or broker website. Kemp’s plan does not affect the current ACA sign-up season for 2020 plans, which starts today.

That change would give Georgia residents access to more health care coverage options, though all plans would have to cover preexisting conditions, the governor’s office said. Georgia would also control billions of dollars in federal subsidies for the Affordable Care Act.

The proposals would require approval from the Trump administration. The governor’s office says it’s been talking to the White House about them.

The state would spend a little over $100 million in 2021 on its reinsurance program, with the remaining funding coming from the federal government, according to the governor's office.

The Kemp administration says the second part of its plan is unique and would help consumers by making it easier to sign up for health care coverage and obtain subsidies. It would also allow them to see other types of health plans, including short-term and catastrophic plans, not just Affordable Care Act-compliant plans.

“I really applaud the efforts” of Kemp and other top officials, said Deb Bailey, executive director of governmental affairs at Gainesville-based Northeast Georgia Health System. “Anytime we have an opportunity to lower insurance rates, improve outcomes, increase affordability and access to our communities, then it’s been a really good day.’

One group, Georgians for a Healthy Future, opposes Kemp’s plan.

“Georgia families and individuals who want comprehensive health coverage may end up paying more, Georgians will have a more difficult time shopping for insurance and consumers will be at a disadvantage when selecting the plan that’s right for them,” executive director Laura Colbert said in a press release.

“The administration’s plan tips the balance of power in health care toward insurers and away from consumers. Each part of this plan helps insurance companies, while consumers shoulder all the risks.”

The Affordable Care Act allowed states to seek waivers from the federal government to change certain provisions.

Thirteen states have had this type of waiver approved by the federal government, including Alaska, Colorado, Delaware, Hawaii, Maine, Maryland, Minnesota, Montana, New Jersey, North Dakota, Oregon, Rhode Island and Wisconsin, according to data from the Kaiser Family Foundation. Twelve of those approved plans asked to use federal funding to help finance state-based reinsurance programs.

“Previous plans that have been denied were all centered around repeal and replacement of the Affordable Care Act,” Miller said.

Georgia Access will instead focus on “giving options and approaches that are unique to (the ACA),” he said.

Miller said he and others were debriefed earlier this week about Kemp’s plans. He said a team has been working on the initiative since nearly the start of the governor’s term.

A roundtable discussion “going into great detail” about the waiver requests is set for Monday, Nov. 4, between the governor and other state officials, Miller said.

Rob Fowler, CEO and partner of Gainesville’s Turner Wood and Smith Insurance, which helped to organize forums explaining the Affordable Care Act, said by email Thursday that it was hard to comment yet on Kemp’s plans, “when they have not released any details of how it is going to work.”

The Associated Press contributed to this report.

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