Georgia ACA waiver granted

[GTFan]

So our state just got a waiver grant which, among other things, will block access to healthcare.gov and instead redirect us directly to providers, brokers, etc. They're not going to create a new state exchange.

https://www.ajc.com/news/georgia-ne...-federal-approval/SGMBBU2KBJAT3JVCMQWLJCC6IE/

What I'm not getting is how the heck we're going to apply for APTC subsidies and get approved based on income since this is handled by healthcare.gov. Are insurers set up to do this now with their own portals?

Very confused as to how they can make this work.

 

[ShokWaveRider]

So our state just got a waiver grant which, among other things, will block access to healthcare.gov and instead redirect us directly to providers, brokers, etc. They're not going to create a new state exchange.

https://www.ajc.com/news/georgia-ne...-federal-approval/SGMBBU2KBJAT3JVCMQWLJCC6IE/

What I'm not getting is how the heck we're going to apply for APTC subsidies and get approved based on income since this is handled by healthcare.gov. Are insurers set up to do this now with their own portals?

Very confused as to how they can make this work.

Use a VPN. Maybe that will work.

 

[PaunchyPirate]

Interesting. I assume they are just going to force you to use brokers or insurance companies that can sell their own plans OR still sell you exchange plans. Here is a link from healthcare.gov that talks about brokers/insurance companies still setting up customers with ACA plans and still getting subsidies.

https://www.healthcare.gov/glossary/agent/

And here is the link that brokers use to sign in and do their business...

https://www.healthcare.gov/lp/agents-and-brokers/

I know that here in PA, I in past years, I could sign up for ACA plans with subsidy at a mall kiosk set up by one of the companies selling insurance in my county. They had a broker portal to do that.

This year, PA has set up our own exchange called Pennie.com. I will have to use it instead of healthcare.gov. The site is not fully populated with plan or insurer data, but I notice that there is a link where I will be able to sign into my account and there is a link where brokers will sign into their account for when they are assisting someone to buy.

 

[cathy63]

According to an article I read about this, it would be effective in 2022, so there's no change in your enrollment for the 2021 plan year.

As I understand it, when you enroll in November 2021 for your 2022 coverage, you'll have to go through a private broker rather than healthcare.gov. That private broker can show you plans that are available in your area of Georgia even if they don't meet the ACA's minimum coverage requirements. If you provide the broker with all your income info, then they should still be able to calculate your actual premiums for each plan by subtracting the subsidy amount from the ACA plan premiums. It's not clear to me whether they will be required to tell you which plans are ACA compliant.

 

[MBSC]

What I'm not getting is how the heck we're going to apply for APTC subsidies and get approved based on income since this is handled by healthcare.gov.

You still qualify for ACA subsidies by using a broker. Georgia would make the subsidy eligibility determination, not HealthCare.gov.

If you don't want to talk to a broker, you will still be able to access alternative sites such as HealthSherpa and GetInsured to enroll with subsidies when they become authorized Georgia web-brokers.

Georgia would assume responsibility for eligibility determinations. The state would validate a consumer’s eligibility for premium tax credits (using ACA eligibility and income requirements) and send this information to the federal government. The federal government would then issue the subsidies to insurers and reconcile subsidies during tax season. Subsidies would only be available for qualified health plans under the ACA, as they are now.

...consumers would transition to a highly decentralized enrollment system that is entirely reliant on web-brokers and insurers.

Reference: https://www.healthaffairs.org/do/10.1377/hblog20200825.344941/full/

 

[GTFan]

You still qualify for ACA subsidies by using a broker. Georgia would make the subsidy eligibility determination, not HealthCare.gov.

If you don't want to talk to a broker, you will still be able to access alternative sites such as HealthSherpa and GetInsured to enroll with subsidies when they become authorized Georgia web-brokers.

Thanks MBSC, was hoping that the expert would step in and point me in the right direction.

I hope that the legal challenge mentioned in that article arises for the new 'market' that GA wants to establish because they have a terrible history of doing anything good in this space. Specifically I predict that their method of verifying eligibility will be a massive fail, at least initially, and that they really won't care because most of the folks affected are low income. Good to know that we can use healthsherpa for enrollment though.

 

[Dtail]

It won't be an issue in Georgia in a few more years I suspect.