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Government suspends Georgia plan for own marketplace instead of federal health insurance exchange

The plan was included in a sweeping healthcare overhaul Gov. Brian Kemp announced in 2020.

ATLANTA — The government informed Georgia on Friday it had suspended approval of a plan to move away from the Affordable Care Act's federal health insurance exchanges for its own private marketplace.

The plan to leave the federal exchanges was announced in 2020 as part of Gov. Brian Kemp's wider healthcare overhaul, and would have taken effect in 2023.

The plan was approved toward the end of the Trump administration. The Biden administration has already previously suspended parts of that approval, including Kemp's plan to expand Medicaid with a work requirement. 

RELATED: Georgia launches lawsuit against Biden admin over revoking Medicaid work requirement approval

Georgia filed a lawsuit against the Biden administration over the work requirement issue in January. It's not yet clear how the state will respond to the government's latest move.

The Centers for Medicare & Medicaid Services (CMS) wrote to Georgia that a research company contracted by the government, Acumen, had found Georgia's plan would result in a drop in health insurance enrollment by Georgia residents of 4.4-8.4% in 2023, and a continuing drop of 8.4% every year from 2024-27. You can read that report here.

Under the Affordable Care Act, states may apply for waivers to certain provisions of the federal law in order to experiment with certain healthcare policies so long as they "provide coverage to a comparable number of residents" and be "at least as comprehensive and affordable as coverage provided without the waiver."

Georgia's plan, the government determined, would not do that. The governor, at the time of announcing his plan, said it would add 33,000 new consumers as an "innovative approach to improving choice in the healthcare marketplace and lowering premium costs."

According to the letter, Georgia will have 90 days to either "respond with a written challenge" or "submit a corrective action plan."

You can read the full letter from CMS here.

   

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