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On Oct. 15, CMS announced it completed the review process for the Georgia Access Model ACA Section 1332  waiver and approved it. The waiver ends the use of the Federally Facilitated Exchange (FFE) in Georgia and creates a reinsurance program for qualified health plans. In the absence of a centralized exchange, plans and brokers will assume expanded roles in marketing, IT, and re-enrollment.

As a result of the waiver, analysts estimate that up to 99,000 Georgians could lose health coverage, mostly from the loss of auto-reenrollment. This is the third iteration of Georgia’s 1332 waiver; the previous two proposals were rejected earlier this year over concerns for lost health coverage.

In September, NADP commented in opposition to the Georgia Access Model, citing concerns that the plan would harm oral health in Georgia and eliminate the FFE as an avenue for individuals to purchase standalone dental plans (SADPs). Below is a link to the full comment letter. NADP was the only organization to raise concerns for dental coverage in the public comments. The waiver will likely face legal challenges, advocates argue the waiver is potentially not in compliance with statutory coverage requirements.

Please contact Government Relations Analyst Owen Urech with any comments or questions.

 

Links

NADP Letter

Georgia Access Model Waiver Full Text

CMS Press Release

CMS Letter of Approval

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