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Gov. Brian Kemp releases plans for health care overhaul
FCN Brian Kemp 4 101418

ATLANTA — 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 could eventually provide subsidies for cheaper coverage that doesn't have to include all of the benefits required by the health law.

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

The ACA proposal calls for the state and federal government 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 $1,000, according to estimates from the governor's office.

Under a second part of the governor's plan, state residents could bypass 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 billions of dollars in federal subsidies 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 remaining funding 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. It would also allow them to see other types of health plans, including short-term and catastrophic plans, not just Affordable Care Act-compliant plans.

It would also give the state flexibility to change the subsidy structure, the governor's office said.

One part of Kemp's plan to provide more health insurance choices involves "association health plans," an option for small businesses and self-employed people that has been widely touted by President Donald Trump. Those and other plans that don't have to meet Affordable Care Act requirements face criticism that they offer skimpy benefits and undercut "Obamacare" by attracting healthy consumers and leading to higher premiums for older or sicker people. Association plans can be offered by small businesses or groups like a local chamber of commerce.

However, they ran into a legal roadblock earlier this year when a federal judge in Washington, D.C., ruled that they were "clearly an end-run" around consumer protections in Obama's law. The Trump administration is appealing that ruling.

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.