The State of Georgia has submitted a modified version of Governor Brian P. Kemp’s “Georgia Access” 1332 State Relief and Empowerment Waiver application to the Department of Treasury (Treasury) and the Centers for Medicare and Medicaid Services (CMS) in the Department of Health and Human Services (HHS) following an additional 15-day public comment period.

Georgia’s 1332 Waiver application submitted to CMS on December 23, 2019 sought to implement a two-part approach consisting of a Reinsurance Program and Georgia Access Model designed to help lower insurance premiums for Georgia families, introduce greater choice in the private health insurance market, and strengthen small businesses across Georgia.

Since that time and during the ongoing approval process, there have been significant changes in the healthcare landscape across the country and in Georgia due to the COVID-19 public health emergency. As a result, Georgia is seeking minor modifications to the waiver application.

The first part seeks to implement a Reinsurance Program starting in Plan Year 2022 rather than Plan Year 2021. The second part also seeks to transition the state’s individual market to the Georgia Access Model starting in Plan Year 2022. Through these changes, Georgia seeks to ensure the success and sustainability of its program and increase access to affordable, quality healthcare coverage for its residents. In the revised application:

The state will not directly issue the subsidies to consumers.

The state will send enrollment and Advanced Premium Tax Credit (APTC)/Premium Tax Credit (PTC) eligibility information to the federal government.

The federal government will continue to issue APTCs and PTCs, as it does without the waiver, which will only be available for Qualified Health Plans (QHPs).

The state is not seeking to certify and provide subsidies for Eligible non-QHPs.

“The Georgia Access plan is focused on lowering costs and improving access to quality healthcare for Georgia patients and families across our state,” said Governor Kemp. “Over the last few months, we have worked closely with the U.S Department of Health and Human Services and Department of the Treasury to ensure the plan meets those objectives. We greatly appreciate their partnership and guidance throughout this process to improve Georgia Access.”

To view the submitted 1332 application, visit https://medicaid.georgia.gov/patientsfirst.