Five years ago, Georgia’s health insurance landscape was inadequate at best.
Over 1.3 million Georgians were uninsured, and 118 of the state’s 159 counties were limited to a single carrier for coverage options.
After years of stagnant enrollment numbers and a lack of carrier options, it was widely understood that vast changes were needed to combat rising healthcare access and affordability challenges sweeping across the state.
Governor Brian Kemp signed the “Patients First Act” on March 27, 2019, authorizing Georgia to submit a Section 1332 waiver and pursue innovative solutions to address the state's healthcare challenges. On Nov. 1, 2020, the State of Georgia received approval for its Section 1332 Waiver to implement a two-part approach.
Part I of the waiver is a five-year reinsurance program designed to lower premiums through increased carrier participation. Part II of the waiver transitions the state’s individual market from the Federally Facilitated Exchange (FFE) to a state-based exchange (SBE) known as Georgia Access.
Georgia Access, a new division within the Office of Commissioner of Insurance and Safety Fire (OCI), is the state’s program for eligible Georgians to shop for and enroll in health insurance coverage in the state’s individual health insurance marketplace. Georgia Access will provide consumers with multiple options to enroll in affordable health insurance coverage through web brokers, agents, and insurance companies.
Georgia Access Executive Director Cheryl Gardner said the program is designed to increase the number of insured Georgians, improve the shopping and enrollment experience, increase competition, and promote innovation and private sector investment in Georgia, as well as help reduce the number of uninsured Georgians.
“We will meet Georgians where they are, to continue to innovate Georgia’s healthcare market,” Gardner said.
Insurance and Safety Fire Commissioner John F. King announced on Aug. 14 that the Centers for Medicare and Medicaid Services (CMS) confirmed approval for Georgia to transition to Georgia Access as an SBE. Georgia Access will go live as the official health insurance marketplace on Nov. 1, as Open Enrollment 2025 commences.
“The Georgia Access approach is an innovative one. It will be the first state-based exchange to partner with private sector companies to get consumers enrolled,” King said. “It represents our commitment to expand access to affordable, quality health coverage and reduce the number of uninsured Georgians.”
King said this change stemmed from three years of work by his office to move Georgia away from relying on the federal government for providing health coverage.
According to state sources, these changes make Georgia’s healthcare marketplace “healthier than ever.” During Open Enrollment 2024, more than 1.3 million Georgians enrolled in marketplace healthcare coverage. Carrier participation has more than doubled since 2019, and no counties are limited to a single carrier for coverage options.
Consumers may begin shopping for health insurance coverage on Nov. 1. For consumers who select a plan by Dec. 16 this year, coverage will begin Jan. 1, 2025.
Visit georgiaaccess.gov for more information.