Georgia is experiencing historic job growth and unmatched economic opportunity in every corner of the state. Participation in the job market is at record highs, unemployment recently dropped to a 20-year low, and we were named the “No. 1 state for business” for the seventh year in a row. But even with rising wages and 30,000 new private-sector jobs this year alone, far too many hardworking Georgians struggle to access and afford health insurance coverage.
During the 2019 legislative session, I championed – and signed into law – the Patients First Act, which empowered my administration to craft Georgia-centric healthcare reform measures that will lower healthcare costs and insurance premiums, enhance access to top-notch doctors and facilities, and ultimately improve health outcomes for Georgia families.
Since then, we have partnered with industry experts, medical professionals, stakeholders, lawmakers, and citizen advocates to draft two unique and innovative healthcare waivers that meet the needs of hardworking Georgians, keep our budget balanced, and reflect our values and vision as a state. These proposals shake up the status quo and put patients – not the special interests – first.
Through the Georgia Pathways program, our state will create a new opportunity for the nearly 408,000 hardworking Georgians who make less than 100% of the federal poverty line (FPL) to afford health insurance. If you are working part-time, enrolled in school, or volunteer in your community at least 80 hours a month, the state will pay for your portion of employer-sponsored insurance or enroll you in Medicaid. Just like commercial insurance, the new enrollee will be required to pay a nominal premium – based on a sliding-fee scale – and rewarded for practicing healthy behaviors.
This new plan does not impact anyone currently enrolled in Medicaid or Medicare. Georgia Pathways is a “hand-up” for hardworking Georgians in our state who are more than deserving. Like the name implies, this reform measure will create a new path to health insurance coverage. As these men and women add hours, build skills, and ultimately earn more, they will transition into our state’s second proposed reform program, Georgia Access.
Since the inception of the Affordable Care Act, the individual insurance market in Georgia has experienced a significant level of instability. Between 2017 and 2019, the average individual insurance plan in Georgia increased between 27% and 41%. For many Georgia families, private sector health insurance coverage is the largest – and most unpredictable – expense in their budget. Many are forced to compromise coverage for affordability while others seek new employment opportunities or take another job to foot the bill.
The second healthcare reform proposal, Georgia Access, creates a state reinsurance program that provides more insurance coverage options, fosters competition among insurance providers, and lowers insurance costs for Georgia families. Like in other states with similar programs, Georgia families who purchase their insurance on the federal exchange will see a noticeable reduction in their premiums – some upwards of double digits.
To generate a better buying experience for Georgia families who currently qualify for health insurance subsidies (100% to 400% of the federal poverty level), the state – if approved by the federal government – will allow Georgia shoppers to bypass HealthCare.gov as the sole insurance enrollment portal. Instead, Georgians will use services offered by a wide array of direct enrollment brokers or simply purchase a plan directly from their insurance provider of choice. Through this proposal, Georgians will have access to more insurance options – not currently offered on HealthCare.gov – that cover those with preexisting conditions. Under Georgia Access, families will have more choices to ensure optimal coverage at the right price.
We know small businesses are the backbone of the Peach State’s economy, employing millions of Georgians. Local employers have always tried to take care of their employees and their families, but with rapidly rising healthcare costs, many can no longer afford to offer full coverage to these hardworking Georgians. Under current law, employers cannot offset the cost of an employee’s health insurance plan purchased through the federal exchange. Georgia Access waives that provision and allows employers to invest in the health and well-being of their employees.
While the two reform proposals will be submitted to the federal government for approval separately, Georgia Pathways and Georgia Access will work in tandem to lift our friends, neighbors, and family members out of poverty. They form a path to opportunity, success, and prosperity for all Georgians – no matter their zip code.
Sadly, there will be opposition to these reform efforts from those who would rather recite political talking points than advance common-sense polices that move the needle on healthcare. They give Georgians a heartless ultimatum: Medicaid expansion or nothing at all. They want to spend over $1.5 billion on a big government program that will bankrupt our state, worsen the doctor shortage, and fail to deliver quality care to those who need it most.
We must put politics aside and do right by those whom we are honored to serve.
There is no “silver bullet” in healthcare – and this, my friends, is the first year of my administration. However, Georgia Pathways and Georgia Access are huge steps in the right direction. These long-overdue reforms will lead to a safe, prosperous, and healthy future.
Brian P. Kemp is governor of Georgia.
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