Here’s what Georgia’s health care reforms could mean for your family

Gov. Brian Kemp unveiled a “Georgia-centric” health-care reform plan Thursday based on newly won federal approval of two waivers to expand health-insurance coverage outside the provisions of the Affordable Care Act (ACA).

Kemp joined Seema Verma, administrator of the Centers for Medicare & Medicaid Services, in signing a waiver allowing Georgia to expand Medicaid coverage to adults with incomes up to 100 percent of the federal poverty level.

Current law limits Medicaid eligibility in Georgia to low-income mothers and children, and to the aged, blind and disabled.


The other waiver, aimed at serving uninsured Georgians who make too much to qualify for Medicaid but too little to receive insurance premium subsidies through the ACA, is to be signed in the coming days.

Stating the problem, Kemp said Georgia suffers from one of the nation’s highest rates of uninsured, while insurance premiums are too high and there’s a lack of competition in the private health-insurance market.

“This status quo is simply unacceptable,” the governor said in announcing the plan at the Georgia Capitol. “It threatens our families and our state’s future.”

The General Assembly passed legislation last year authorizing Kemp to pursue the two waivers. The state hired Deloitte Consulting to help develop the waiver applications, which were submitted to CMS late last year.

The Medicaid waiver will make Georgians earning up to $12,000 a year eligible to enroll in Medicaid or employer-sponsored health insurance if they spend at least 80 hours per month engaged in a “qualifying activity” Those include employment, on-the-job training, participating in job-readiness activities, vocational training, higher education or community service.

“We’re making health insurance accessible for those who need it most,” Kemp said.

The second waiver will replace the ACA’s healthcare.gov insurance enrollment website and let Georgians enroll directly with insurance carriers, local brokers or private sector web-broker sites.

Kemp said enrollment through the healthcare.gov portal has declined by 22% since 2016. He blamed the site’s cumbersome nature for the decrease.

“Healthcare.gov has fundamentally failed Georgians,” Kemp said. “The enrollment process has been nothing short of disappointing.”

The second waiver will cover Georgians earning between $12,000 and $51,000 annually.

Many Democrats voted against the Medicaid waivers legislation last year, arguing Georgia should join the majority of states that have expanded Medicaid coverage under the ACA to those making up to 138% of the federal poverty level.

But Kemp said Thursday that would be too expensive. He said the $218 million annual price tag of his Medicaid expansion plan is less than half what the state would pay under the Democrats’ proposal.

Verma praised Georgia for becoming the first state to take advantage of the unprecedented flexibility the Trump administration is offering through the health-insurance waiver process.

“We have delivered by getting Washington, D.C., out of your health care,” she said. “We have worked to empower states.”



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