Finding best healthcare for Georgians
Most Americans get their health insurance from one of two providers: either through the government or from commercial health plans.
While the government provides taxpayer-funded health insurance to seniors (Medicare) and to the low-income and disabled population (Medicaid), commercial health insurance is typically a benefit provided by employers or acquired by families and individuals on health insurance exchanges.
Despite the growing popularity of other methods to pay for healthcare, such as direct primary care, health care sharing ministries and utilizing price transparency platforms for the best cash pay rates, the government and commercial health plans remain the primary payers for providers.
Which brings us to
The 1332 waiver, known as Georgia Access, allowed the state to establish and operate its own health insurance exchange as the replacement to Health-Care.gov, the federal marketplace established under the Affordable Care Act. It also established a reinsurance program that "insures the insurers" by mitigating the financial impact of high-cost claims which drive up the cost of health insurance for everyone on the health plan. The Foundation recently published "Examining Georgia's
As the author notes, in 2018, 145
Choice and competition in the health insurance market are not only good for consumers, but providers as well. That one insurance carrier that operated in 2018? It was reimbursing hospitals and physicians on average
What we pay providers is important to sustaining a robust healthcare community. For example, as manufacturers migrated out of the country in recent decades, healthcare providers suddenly had to deal with patients who lacked commercial health insurance - which reimburses providers at the highest level - and were subsequently underinsured or uninsured completely.
Which brings us back to Medicaid, a health insurance program that reimburses providers 80 cents on the dollar; as such, only 60 percent of
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