Georgia governor releases plans for health care overhaul

ATLANTA (AP) — Georgia Gov. Brian Kemp unveiled a much-anticipated plan Thursday that aims to reduce premiums for residents who buy health insurance under the Affordable Care Act and give the state control of billions of dollars in federal health care funds.

The proposal could eventually lead to subsidies for cheaper coverage that doesn't include all the benefits required by the ACA.

The plan does not address Medicaid coverage. The Kemp administration is expected to release its Medicaid plans next week.

Kemp said at a news conference his proposal would give Georgia families "more stability and predictability."

"For many Georgians, health insurance is the largest and most unpredictable expense in a family budget," he said.

The ACA proposal calls for the state and federal governments to pay a portion of insurance companies' costs to treat their sickest patients, a relatively small group that incurs the biggest bills. The so-called reinsurance program would allow the companies to lower monthly premiums for all customers.

The reduction could be as much as $282 in areas of Georgia where premiums now exceed $1000, according to estimates from the governor's office.

Under a second part of the governor's plan, state residents could bypass Healthcare.gov and sign up for insurance directly through an insurance provider or broker website. Kemp's plan does not affect the current ACA sign-up season for 2020 plans, which starts Friday.

That change would give Georgia residents access to more health care coverage options, though all plans would have to cover preexisting conditions, the governor's office said. Georgia would also control $2.7 billion in federal subsidies each year for the Affordable Care Act.

The proposals would require approval from the Trump administration. The governor's office says it's been talking to the White House about them.

The Affordable Care Act — President Barack Obama's signature health law — allowed states to seek waivers from the federal government to change certain provisions.

Thirteen states have had this type of waiver approved by the federal government, including Alaska, Colorado, Delaware, Hawaii, Maine, Maryland, Minnesota, Montana, New Jersey, North Dakota, Oregon, Rhode Island and Wisconsin, according to data from the Kaiser Family Foundation. Twelve of those approved plans asked to use federal funding to help finance state-based reinsurance programs.

Georgia would spend a little over $100 million in 2021 on its reinsurance program, with the remainder coming from the federal government, according to the governor's office.

The Kemp administration says the second part of its plan is unique and would help consumers by making it easier to sign up for health care coverage and obtain subsidies. Bypassing Healthcare.gov would also allow them to easily see other types of health plans, including short-term plans and association health plans that are not compliant with the Affordable Care Act.

Critics say those plans can offer skimpy benefits, saddle people with high out-of-pocket costs and undercut "Obamacare" by attracting healthy consumers and leading to higher premiums for older or sicker people.

Using ACA tax credits for short term plans would "further destabilize the market," said Laura Harker, a senior policy analyst at the Georgia Budget & Policy Institute.

"As more Georgians struggle to access health care, state leaders should rework their plans and focus on extending comprehensive health care coverage to as many Georgians as possible," she said in a statement.

Kenneth Thorpe, an expert in health care reform at Emory University, said there's much to like about Kemp's plan, though he raised concerns that higher out-of-pocket costs for non-compliant plans could dissuade people from continuing treatment.

"It will all be in the detail of how it's administered" and how federal health care officials view it, he said.

Health care policy became a key issue in Kemp's hotly contested race for governor last year against Democrat Stacey Abrams, with Kemp frequently assailing the Affordable Care Act and Medicaid as government programs that cost too much and fail to deliver for patients. Abrams strongly backed a full expansion of Medicaid allowable under the Affordable Care Act, while Kemp promised to deliver more affordable health care options for Georgia without expanding Medicaid. Abrams said she would explore creating a reinsurance program.

Associated Press writer Ricardo Alonso-Zaldivar in Washington, D.C. contributed to this report.