ACA Georgia  Marketplace (exchange) allows individuals who don’t have an employer-offered plan or qualify for Medicare to sign up for private health insurance. The ACA provides significant tax subsidies to help offset insurance costs for low-income individuals. More than 318,000 Georgians signed up for ACA marketplace coverage this year.

Georgia has submitted a Section 1332 waiver application to the federal Centers for Medicare and Medicaid Services, seeking to change the way the ACA Marketplace operates. If approved, the state would run its own ACA exchange website and take over enrollment functions. The state would also create its own subsidy program, called Georgia Access, to subsidize premiums for individual policy holders.

Exploring ACA in Georgia: Affordable Care Act Insights

The waiver’s own economic and actuarial analysis purports to show that 25,000 Georgians will gain coverage as a result of the change. But more realistic analysis shows that the waiver should be expected to cause large losses in coverage – exacerbating the very problem it claims to address.

Moreover, Georgia’s own analysis shows that implementing the waiver could lead to higher marketplace premiums, because it will encourage healthy individuals to move to cheaper plans that do not comply with the ACA’s minimum benefit requirements. These plans are likely to exclude many of the most expensive, life-saving benefits included in the ACA’s marketplace plans. This will drive up premiums for older and sicker people, leaving fewer people with comprehensive health coverage. This is especially true for Blacks and Hispanics, who are disproportionately affected by the coverage gap.