Georgia

(Note: Most of this is a shortened version of my post from seven weeks ago...with a pretty important update at the end):

Just over a year ago, Bright HealthCare, which was only founded in 2016, announced that they were dramatically expanding their operations around the U.S.:

Bright HealthCare Expands Affordable Plans in 42 New Markets Next Year Including in Texas, Georgia, Utah and Virginia

Sherman, set the Wayback Machine to 2015:

MICHIGAN: Another One (Mostly) Bites The Dust; 12th CO-OP Drops Off Exchange, May Go Belly-Up

It appears that East Lansing-based Consumers Mutual Insurance of Michigan could wind down operations this year as it is not participating in the state health insurance exchange for 2016.

But officials of Consumers Mutual today are discussing several options that could determine its future status with the state Department of Insurance and Financial Services, said David Eich, marketing and public relations officer with Consumers Mutual.

Consumers Mutual CEO Dennis Litos said: "We are reviewing our situation (financial condition) with DIFS and should conclude on a future direction this week.”

While Eich said he could not disclose the options, he said one is “winding down” the company, which has 28,000 members, including about 6,000 on the exchange.

Georgia

Back in April, I did some minor champagne cork popping after the Centers for Medicare & Medicaid Services rightly put the kibosh on the so-called "Georgia Access Model" waiver pushed by GOP Governor Brian Kemp:

The Georgia Access model would eliminate the use of HealthCare.gov, transitioning consumers to decentralized enrollment through private web-brokers and insurers. The state would establish its own subsidy structure to allow for 1) the subsidization of plans that do not comply with all the ACA’s requirements; and 2) enrollment caps if subsidy costs exceed federal and state funds.

There's not a single part of the paragraph above which shouldn't be setting off major alarms:

Georgia

Back in April, I did some minor champagne cork popping after the Centers for Medicare & Medicaid Services rightly put the kibosh on the so-called "Georgia Access Model" waiver pushed by GOP Governor Brian Kemp:

The Georgia Access model would eliminate the use of HealthCare.gov, transitioning consumers to decentralized enrollment through private web-brokers and insurers. The state would establish its own subsidy structure to allow for 1) the subsidization of plans that do not comply with all the ACA’s requirements; and 2) enrollment caps if subsidy costs exceed federal and state funds.

There's not a single part of the paragraph above which shouldn't be setting off major alarms:

Georgia

Back in April, I did some minor champagne cork popping after the Centers for Medicare & Medicaid Services rightly put the kibosh on the so-called "Georgia Access Model" waiver pushed by GOP Governor Brian Kemp:

The Georgia Access model would eliminate the use of HealthCare.gov, transitioning consumers to decentralized enrollment through private web-brokers and insurers. The state would establish its own subsidy structure to allow for 1) the subsidization of plans that do not comply with all the ACA’s requirements; and 2) enrollment caps if subsidy costs exceed federal and state funds.

There's not a single part of the paragraph above which shouldn't be setting off major alarms:

Georgia

Georgia's health department doesn't publish their annual rate filings publicly, but they don't hide them either; I was able to acquire pretty much everything via a simple FOIA request which was responded to within an hour of my asking.

There's one significant development apiece in Georgia's individual & small group markets:

INDIVIDUAL: A few years ago, Georgia's GOP Governor, Brian Kemp, put in a request to the Centers for Medicare & Medicaid Services (CMS) for what's known as a Section 1332 State Innovation Waiver. If approved, these waivers allow individual states to modify how the ACA operates in their state as long as they can prove that the changes would a) cover at least as many residents b) at least as comprehensively without c) increasing federal spending in the process.

Georgia

Back in November I put out a Break Glass In Case Of Fire-style call to action:

About 2 years ago, GOP Georgia Governor Brian Kemp submitted an ACA Section 1332 Waiver request to the Centers for Medicare & Medicaid Services. As Katie Keith of Health Affairs explained at the time, it consisted of two parts...the first of which was fairly noncontroversial, the second of which was...well, not good:

The application reflects a two-phase approach: a state-based reinsurance program to begin in plan year 2021, followed by a transition to the “Georgia Access” model beginning in plan year 2022. Both components of the waiver application would extend through plan year 2025.

With the Build Back Better Act having passed the U.S. House of Representatives last fall only to come screeching to a halt when it reached the U.S. Senate due to all 50 Republicans + Dem. Senator Joe Manchin refusing to support it, Congressional Democrats have started introducing standalone bills in an attempt to push through at least some of the more popular provisions.

One of these, which would limit co-pays for insulin to no more than $35/month or less, passed the House last week.

Today, U.S. Senator Raphael Warnock, who also sponsored the Senate version of the insulin co-pay cap bill, introduced a second stand-alone bill plucked from the ashes of Build Back Better:

Senator Reverend Warnock Introduces New Legislation to Cap Prescription Drug Costs for Georgia Seniors

Georgia

UPDATE 12/17/21: I've already submitted my comment to the Health & Human Services Dept. Now, the National Health Law Program’s My Care Counts project has created an easy-to-use public comment tool for you to submit your own. PLEASE DO SO before January 9th!

MAKE SURE *NOT* TO USE THE GENERIC DEFAULT LANGUAGE IN THE FORM, HOWEVER; MAKE IT YOUR OWN.

See the rest of the post below for the background/details on this issue.

About 2 years ago, GOP Georgia Governor Brian Kemp submitted an ACA Section 1332 Waiver request to the Centers for Medicare & Medicaid Services. As Katie Keith of Health Affairs explained at the time, it consisted of two parts...the first of which was fairly noncontroversial, the second of which was...well, not good:

Rate Changes

As I noted last night, thanks to the federal Rate Review website finally being updated to include the final, approved 2022 rates for both the individual and small group markets in all 50 states (+DC), I've been able to fill in the missing data for my annual ACA Rate Change Project.

As I note there, the overall weighted average looks like it'll be roughly +3.5% nationally.

Normally I write up a separate entry for both the preliminary and approved rate changes in each individual state, but it seems like overkill to create 14 separate entries at once. Besides, in many of these states there's been few if any changes between the preliminary and approved rate changes.

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