Less Coverage and More Risk: Sounding the Alarm on Kemp’s 1332 Waiver

Indivisible Georgia Coalition - Healthcare Alert


Call to action: Contact the chair of the appropriations committee, Rep. Terry England at terry.england@house.ga.gov and ask him to not allow further cuts to public healthcare services in Georgia. The Governor pushed through these harmful waivers last year that are unlikely to be approved and leaves many Georgians without access to healthcare. The proposed budget cuts will leave even more uncovered. Both the waivers and budget cuts do not add up for Georgians, we deserve better.

Deeper dive:
Advocates in Georgia have repeatedly warned that our healthcare crisis must be addressed in a comprehensive manner.  The lack of statewide, affordable coverage constitutes an emergency that has remained unaddressed for far too long. 

When Governor Kemp and state legislators rejected full Medicaid expansion, and instead sought 1115 and 1332 waivers, healthcare experts were understandably cautious.  Based on everything revealed thus far, we know that waivers are highly risky – offering less coverage at greater expense.   

Now we have an even clearer picture of the devastating effects of the proposed 1332 waiver on Georgians.  The most recent examination of Kemp’s plan by the Brookings Institute provides a scathing assessment:

Under Section 1332 of the Affordable Care Act (ACA) a state can develop alternative healthcare coverage models, as long as the proposal meets four statutory guardrails:

1. Provide coverage that is at least as comprehensive as without the waiver;

2. Provide coverage that is at least as affordable as without the waiver;

3. Cover at least a comparable number of state residents; and 

4. Does not increase the federal deficit.

The version of the waiver Georgia submitted for federal review fails the Section 1332 tests. Specifically, it does not meet the requirements that waivers cover as many people, with coverage as affordable and comprehensive, as would have been covered without the waiver. The plan would likely leave many Georgians with less affordable or less comprehensive coverage than they would otherwise have under the ACA. 

Kemp’s 1332 waiver would remove direct subsidies currently available in exchange for a state-administered fund.  Analysis indicates the state plan will be underfunded and likely result in rationing. 

Additionally, the proposed 1332 waiver would block consumers from using healthcare.gov to sign up for insurance.  The new state-based marketplace would rely on private brokers or insurers, who would be incentivized to steer consumers towards substandard, non-ACA compliant plans. The proposal would drop requirements that insurers provide platinum or gold level plans. Instead, the waiver would authorize “copper” level and “disease management” healthcare plans.  Watering down ACA protections regarding essential benefits will result in higher deductibles and exorbitant out-of-pocket costs.  

Kemp’s risky strategy will overhaul the state’s healthcare market and undermine the financial assistance available to middle and low income consumers.   On a macro level, the proposal is fiscally irresponsible and is dependent on unrealistic assumptions. This “up is down, black is white” mentality may be politically expedient but at what cost?  Blindly gambling with Georgian’s healthcare coverage is not a risk we should endure.  

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