Many individuals in Georgia may have a new option for health insurance.
Gov. Brian Kemp on Thursday announced the state has approved a new health plan that the insurance company Anthem will offer through the Georgia Farm Bureau, which claims 300,000 “member families,” including Kemp himself.
“This is an exciting moment for our state, one of many that will reform our current health care system,” Kemp said as he made the announcement, flanked by Anthem’s Georgia president, Pam Stahl, the president of the Georgia Farm Bureau, and the state’s acting insurance commissioner.
Kemp said the move was intended to give better health options to rural Georgians and work on lowering health care premiums.
The move pushes Georgia insurance in a more conservative direction. According to state and company insurance officials, the new plans can do something that plans under the Affordable Care Act can’t do: They can charge more money for people who are sicker, such as those with pre-existing conditions, and lower prices for people who are healthier.
Experts say that means the new plans will draw healthy, cheap clients away from regular individual market plans sold on the Affordable Care Act exchange. The sicker people will be left in the regular market, making it a more expensive place to obtain insurance.
“What it’s going to do is it’s going to allow healthier people to go in and get a better rate,” said Katie Keith, a professor of health law at Georgetown University. “And you’re inevitably going to increase premiums for people with pre-existing conditions.”
Experts including Keith were puzzled at exactly how Georgia and Anthem were engineering the plan to make it legal under federal law.
The Affordable Care Act mandated certain rules for insurance, and conservative states and the Trump administration have looked for loopholes.
This plan is called a Multiple Employer Welfare Arrangement, and it involves similar businesses banding together in an association in hopes of receiving the same treatment as big employers that don’t have to comply with as many rules as smaller firms under the ACA.
The Georgia Farm Bureau is a very big association, and Stahl said the plans will be available to companies throughout Georgia with from two to 50 employees or even a sole proprietor. Stahl said the plan will be open to farms and “farm-related” businesses that have been designated as agriculture under the Standard Industrial Classification code, a system once devised by the federal government and still employed by some agencies and financial organizations.
State officials referred questions about what other requirements might exist — for example, could an Atlanta resident with a garden get an SIC number, join the Farm Bureau and qualify — to the Farm Bureau. The Farm Bureau did not return phone messages.
Laura Colbert is director of the group Georgians for a Healthy Future and has advocated for shoring up the Affordable Care Act. She voiced mixed feelings about Thursday’s announcement. Such plans “can be a good way to provide coverage for employees of small businesses,” she said.
“However, given that Governor Kemp and other state leaders have … expressed interest in wanting to reduce premiums for Georgians, this announcement could run counter to those efforts. Essentially, the proposal has the potential to pull enrollees out of the market. And one of the important things for an affordable market is, you have as many people in the risk pool as possible.”
State officials pointed out that the market isn’t great for everyone: Many Georgia counties have only one plan option on the regular individual market, and if they barely make too much to qualify for subsidies, they’re hit with very high premiums.
Georgia’s acting insurance commissioner, John King, said the move just gives Georgians “more insurance options at better rates.”
Stay on top of what’s happening in Georgia government and politics at www.ajc.com/politics.
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