Feds deny Kemp’s health insurance marketplace waiver

The federal agency in charge of Medicaid Tuesday denied Georgia’s application for a waiver to set up the state’s own health insurance marketplace.

The waiver program was a cornerstone of Republican Gov. Brian Kemp’s approach to reforming health care in the Peach State. Under Kemp’s model, Georgians would have enrolled in insurance plans through private insurance brokers rather than the federal healthcare.gov health insurance marketplace.

The plan to set up Georgia’s own marketplace system initially gained federal approval under then-President Donald Trump in November 2020. But after the Biden administration took office, the U.S. Department of Health and Human Services (HHS) asked Georgia to submit a revised plan for the waiver that would reflect new federal policies and rules.

Georgia challenged the HHS findings and did not submit the requested changes to the plan. Kemp argued at the time that the healthcare.gov website was cumbersome and inefficient.

Now, HHS has suspended Georgia’s waiver plan.

A letter Tuesday from Chiquita Brooks-LaSure, administrator of the agency’s Center for Medicare and Medicaid Services (CMS), outlined some of the problems with the Georgia waiver plan that led the agency to suspend it.

Georgia did not provide the federal government with sufficient information to prove that its plan for health insurance would prevent coverage losses, the letter noted.

Georgia also did not provide HHS enough information about how it planned to communicate about the new marketplace and engage underserved populations. The program was not yet ready to go live, according to the federal letter. “Consumers in Georgia will continue to use HealthCare.gov, which CMS will operate, to purchase individual health insurance coverage for 2023,” a CMS spokeswoman said. She also noted that Georgia could still submit a corrective action plan that would allow the state to implement the plan in the future. “We’re evaluating our options based on CMS’ decision,” said Katie Byrd, a spokeswoman for Kemp. Democratic U.S. Sen. Raphael Warnock praised the move. “Permanently suspending the state’s harmful Section 1332 waiver will ensure that Georgians will be able to keep purchasing affordable health care coverage,” Warnock said Tuesday. “This will save lives and save families money.”

This story is available through a news partnership with Capitol Beat News Service, a project of the Georgia Press Educational Foundation.