Hey guys - big news from Georgia this week you might have missed. I figured it was important enough to bring up in this group to gather some thoughts.
Essentially, Georgia has been making quite a few big Medicaid moves lately. The state partially expanded Medicaid while also implementing work requirements to qualify for coverage for certain individuals.
- This week, the state went a step further by applying for a 1332 state innovation waiver in order to overhaul Medicaid further and remove the healthcare.gov portal. The move might have major implications for the future of health care
Here's the previous write-up from my newsletter with pros & cons of the move:
Big state news this week: CMS approved Georgia's reinsurance program waiver. That means starting in 2023, people in Georgia on ACA plans will have to purchase insurance directly through insurance websites or web brokers RATHER than through healthcare.gov.
- As another key component of the 1332 state innovation waiver, CMS would incentivize health insurers to participate in these exchanges by offering protection against catastrophically high claims.
Critics of the waiver argue that the shift from Healthcare.gov could confuse people, leading to lower coverage for 500,000 individuals on ACA plans. Georgia has the highest uninsured rate in the country at 13.7%. Then there's the whole question of whether the policy is legal under the ACA. Read the critics' viewpoint here.
Proponents of the waiver think that the policy will lower health care costs in the state and provide more choice in plans for Georgians. CMS thinks that premiums could drop 13% on average beginning in 2023. Further, ACA enrollment dropped 22% on average between 2016 and 2019. Read the CMS press release here.
- Bigger picture: What Georgia is doing could be the future of Medicaid under the Trump administration. Reinsurance programs, Medicaid work requirements, and more privatization. The news comes at the beginning of open enrollment period for Obamacare.
Would love to hear thoughts on this.
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