People with below-average incomes already receive hefty subsidies when they buy insurance through the ACA exchange. The bigger beneficiaries under the waiver proposal would be those who make above-average incomes. Right now, a family of four that makes $103,000 per year or more would receive no subsidy under Obamacare. Under Kemp’s plan, though, they would benefit from lower premiums just like anyone else.
Such proposals have been tried in other states and given approval to go forward. A key to making them work is making the subsidies big enough, and experts said the Georgia proposal contains a healthy subsidy.
The rest of Kemp’s ACA exchange waiver proposal is far more controversial. Kemp asked the federal government to consider the two parts separately in order not to delay the insurance subsidy plan. The U.S. Centers for Medicare and Medicaid Services agreed.
Those other parts of the waiver would allow the state to take control of the federal subsidies that lower costs for lower-income policyholders on the ACA exchange market. The state would spread the subsidies to coverage that isn’t eligible now, such as short-term plans that pay for fewer services and plans bought with the help of an employer. The state would also eliminate Georgians’ access to the healthcare.gov website.
The CMS has asked Kemp’s office for more information about those parts.
Loke said the request for information was not a surprise. “Given the novelty to the approach — we expected that supplemental information would be required, and have worked with our federal partners to begin putting together the necessary information for their review.”
Comment about the plan to subsidize insurers' costs opened Thursday and will close March 7. People can email their comments to StateInnovationWaivers@cms.hhs.gov. Put "Georgia Section 1332 Waiver Comments" in the subject line and include your name and email address.
The state budget for fiscal 2021 is facing a money crunch, and six months of the program would occur during that year. However, Loke said the state did not need to start looking for $50 million to take out of the next budget year because the way the system works, the cash wouldn’t flow right away.
STATE RESOURCES: Click here for resources on Georgia’s ACA waiver and Medicaid waiver