Kemp in standoff with Biden administration over plan to block ACA site

The website for shopping for health insurance plans on the Affordable Care Act exchange marketplace, healthcare.gov.

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The website for shopping for health insurance plans on the Affordable Care Act exchange marketplace, healthcare.gov.

State spent $31M on proposal to block Georgians from shopping on healthcare.gov

Georgia has spent $31 million on Gov. Brian Kemp’s embattled proposal to block Georgians from shopping for health insurance on the federal healthcare.gov website, Kemp’s office told the Biden administration in a letter on Thursday.

Kemp’s office suggested in the letter that the Biden administration was attempting to overturn the Trump administration’s approval of the Georgia “waiver” plan. The letter said that rescinding the previous administration’s approval would not only be illegal, it would also make a waste of that $31 million investment.

Kemp has argued that Georgians will find it easier to shop for insurance from private companies, because they are more motivated to be consumer-friendly. Opponents say that private companies actually put their own profits over the need to fully explain all options to consumers. They say consumers already have the ability to shop for insurance from private companies, and they choose not to.

Just over 700,000 Georgians purchased plans for 2022 coverage on the Affordable Care Act marketplace exchange. The vast majority do so via healthcare.gov. On healthcare.gov, unlike individual companies’ sites, a shopper sees all eligible plans placed together so they can compare them.

The “waiver” proposal would block Georgians from shopping on healthcare.gov. The proposal, drawn up by Kemp aides working with officials in the Trump administration, would instead direct Georgia shoppers to contact information for private insurance companies and brokers to get help. Consumers in Georgia already have access to those private companies and websites. They can also use a privately run version of healthcare.gov that some agents think works better, healthsherpa.com. Georgians would continue to have access to that under Kemp’s plan.

Supporters of the waiver plan said it would produce more options for Georgians. That should mean more health insurance plans to choose from, said Chris Denson, director of policy and research at the Georgia Public Policy Foundation, a libertarian-leaning think tank. “The state received approval from (the federal government in 2020) to proceed with the implementation,” and the Biden administration has no authority to undo that, Denson said.

Opponents of the Kemp plan say that on the contrary, research shows that both private companies and private insurance agencies instead try first and foremost to make the biggest profit they can. They say studies show a history of selling consumers plans that don’t meet their needs the best.

“Governor Kemp’s plan to shut down the most popular enrollment pathway for Georgians buying their own health insurance is a gamble,” betting that people won’t give up on shopping for insurance entirely, said Laura Colbert, director of Georgians for a Healthy Future, an organization that supports the ACA and Medicaid expansion.

The waiver was approved by the Trump administration two days before the 2020 election, which left the waiver’s implementation to the Biden administration. Knowing that if Trump lost the election a Biden administration would likely look askance at the proposal, Trump aides changed its standard contract to make it harder for any future administration to revoke the waiver.

Indeed, the letter from Kemp’s office is the latest salvo in a battle between the Kemp administration and the Biden administration over Kemp’s health care waiver proposals. Rather than providing a “corrective action plan” as Washington had demanded, Kemp’s office instead pushed back in the letter and said Washington was just trying to stop the proposal. The standoff virtually assures that the battle will wind up in court.

Colbert said that the plan the feds requested “simply asked that Georgia better detail its ‘outreach and communications plan, including planned funding, a spend plan, and additional information on engagement with underserved communities.’” but that Georgia had refused to do that. “After spending $31 million and ‘thousands of hours of staff time’ on the planning and implementation of Governor Kemp’s signature health care policy, surely the state has these plans in place already and the plans would be easy to share.”

The Georgia letter countered that the Biden administration has asked for data that would be impossible to produce within the time frame it demanded.

Kemp’s director of health strategy and coordination, Grant Thomas, signed the letter. He did not specify what the $31 million had been spent on.

A spokesman for Kemp, Andrew Isenhour, also did not list out expenditures. But he said that the money included both state and federal dollars, and was spent on “technical system needs and digital architecture services, consulting and project management services, a public awareness campaign, and general program consulting support.”

The Georgia letter said the numbers speak for themselves.

“For many Georgians, HealthCare.gov is difficult to navigate. That is why, despite offering billions in federal premium tax credits over the years for people seeking insurance through that portal, almost one million Georgians eligible for subsidies remained uninsured.”

The number of uninsured who are eligible for subsidized ACA plans is now just over half a million. Anyone can buy a plan under the ACA, but federal subsidies are available subject to income limitations.

Laura Harker, a Georgia-based senior policy analyst at the left-leaning Center on Budget and Policy Priorities, argued that people instead remain uninsured for a variety of reasons, including that the deductibles may be too high or they can’t afford even the subsidized premiums.

EDITOR’S NOTE: This story has been updated to clarify that Laura Harker of the Center on Budget and Policy Priorities is Georgia-based; the Center’s headquarters are in Washington, D.C.