Senator Reverend Warnock, Representative McBath pressured Centers for Medicare and Medicaid Services (CMS) Administrator to not approve Georgia’s plan to operate a state-based exchange in fall of 2023 if the state’s plan could result in coverage losses for Georgia families

The state is operating on a hasty timeline which might not comply with the federal rules

Additionally, as the state unwinds Medicaid’s “continuous coverage,” tens of thousands of Georgians may find themselves looking for coverage on the health care marketplace. In which case, switching from a federal exchange to a state-based exchange will only add to the confusion

The federal Healthcare.gov exchange provides coverage to over 800,000 Georgians

Last January, Senator Reverend Warnock successfully led the Georgia Democratic delegation effort in pressuring CMS to rescind a Trump-era waiver, which approved the creation of the Georgia Access Model—a system that would restrict access to health care coverage for hundreds of thousands of Georgians by eliminating access to HealthCare.gov in Georgia

Senator Reverend Warnock: “As more people look for health care on the federal exchange, we need to ensure a seamless process… This is not the time to experiment with people’s health care”

Representative McBath: “As a two-time breast cancer survivor, I was lucky to have access to quality, affordable health care. Every Georgian deserves that right. No hard-working family should ever be forced to choose between paying for a mortgage, or the medicine they need to stay healthy and whole”

Washington, D.C. — Today, U.S. Senator Reverend Raphael Warnock (D-GA), a champion for affordable health care access, and Representative Lucy McBath (D-GA-7) pressured Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure to not approve Georgia’s request to operate a state-based health care exchange fall of 2023 if the state’s plan could result in coverage losses for Georgia families. Senator Warnock and Representative McBath pointed out that in a year when tens of thousands of additional Georgians will likely look to sign up for coverage on Healthcare.gov following the winding down of Medicaid’s “continuous coverage,” this is the exact wrong time for Georgia to add to the confusion by rolling out a hastily-prepared state-based exchange, especially on an accelerated timeline that may not comply with federal rules. Confusion surrounding the state-based exchange, could lead to thousands of Georgians losing coverage. Senator Warnock and Representative McBath reaffirmed that CMS’s top priority should be to prevent health care coverage loss.

“We believe CMS’s first priority should be to ensure health coverage for Georgians, and we are committed to doing what we can in Congress to expand health care coverage to all Georgians and to prevent coverage losses for Georgia families,” said Senator Reverend Warnock, Congresswoman McBath to CMS Administrator.“As such, we encourage you not to permit Georgia to transition to a state-based exchange on an accelerated and hasty timeline that could result in the loss of health care coverage for Georgia families.”

“As more people look for health care on the federal exchange, we need to ensure a seamless process,” said Senator Reverend Warnock. “I’m urging CMS to take steps to make sure Georgians can easily access the coverage they need. This is not the time to experiment with people’s health care.”

“As a two-time breast cancer survivor, I was lucky to have access to quality, affordable health care,” said Representative Lucy McBath. “Every Georgian deserves that right. No hard-working family should ever be forced to choose between paying for a mortgage, or the medicine they need to stay healthy and whole.”

Last January, Senator Reverend Warnock successfully led every Democrat in Georgia’s congressional delegation in calling for federal health care regulators to rescind Part II of Georgia’s section 1332 waiver, the Georgia Access Model — a system that would restrict access to health care coverage by eliminating access to HealthCare.gov in Georgia. In the past two years and thanks to Senator Warnock’s leadership, Georgia has seen an increase of insured individuals on the federal exchange – in part because of the American Rescue Plan Act and the Inflation Reduction Act, which expanded premium tax credits to make coverage more affordable.

Read the full letter here or below:

Dear Administrator Brooks-LaSure,

We write to request that you not approve Georgia’s plan to operate its own state-based health insurance exchange for plan year 2024 if the Centers for Medicare and Medicaid Services (CMS) has reason to believe this approval could result in coverage losses for Georgia families. Approving this request may not comply with federal rules, which require a state seeking to set up a state-based exchange to submit an Exchange Blueprint at least 15 months before the state-based exchange’s first open enrollment period and to have an approved or conditionally approved Blueprint and operational readiness assessment at least 14 months prior to launching. We are concerned that an exception for Georgia at this time would put Georgians at higher risk of coverage loss.

This fall and in early 2024 when Georgia proposes to launch its exchange, the unwinding of the Medicaid “continuous coverage” provision will be well underway. Georgia will be in the midst of reviewing the eligibility of millions of enrollees and terminating Medicaid coverage for those who are no longer eligible, or who are eligible but do not complete paperwork requirements or are otherwise unable document their eligibility. Many Georgians could be eligible for health coverage through the federal healthcare.gov insurance exchange, and we are concerned that a new, state-based exchange in Georgia would only add to the confusion and complexity for people who are terminated from Medicaid coverage and who will become uninsured unless they take action to transition to an exchange plan.

This summer, the state is also planning to implement a new section 1115 waiver program that will require certain low-income adults to meet a work-reporting requirement in order to obtain and keep Medicaid, further complicating the coverage landscape in Georgia and straining the state’s operations during unwinding. Maintaining the federally-run healthcare.gov exchange in Georgia, which successfully provides coverage to more than 800,000 people today, will create greater stability and consistency for Georgians.

Even without major changes to the state’s exchange, coverage losses during this tumultuous period are predicted to be significant. National projections show that children, young adults, and communities of color are likely to be hardest hit. According to the U.S. Department of Health and Human Services’ own analysis, nearly 15 percent of those projected to lose coverage during unwinding are Black and one-third are Latino.

Georgia’s state leadership previously pursued a section 1332 waiver that would have eliminated healthcare.gov entirely and replaced this one-stop shop with a requirement for Georgians to enroll in coverage directly through an insurer, agent, or broker. We opposed this waiver and were relieved to see it suspended. Now, state officials argue that work done to advance that waiver should allow it to quickly set up a state-based exchange. We disagree. The State of Georgia should meet the specific requirements related to establishing a state-based exchange meant to safeguard Georgians from coverage loss, including federal rules designed to make this a deliberate and careful process.

We believe CMS’s first priority should be to ensure health coverage for Georgians, and we are committed to doing what we can in Congress to expand health care coverage to all Georgians and to prevent coverage losses for Georgia families. As such, we encourage you not to permit Georgia to transition to a state-based exchange on an accelerated and hasty timeline that could result in the loss of health care coverage for Georgia families.

Sincerely,

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