Republicans are still gunning for Obamacare -- and Georgia's GOP governor has a new scheme to help the party destroy it

Team Trump hasn’t been able to kill off Obamacare yet, even with stacking our nation’s courts, so at least one Republican governor will make it more difficult for people to buy health insurance.

Brian Kemp, Georgia’s Republican governor who bungled his state’s response to the pandemic, has received federal approval to cut off access in 2023 to HealthCare.gov, the easy-to-use online marketplace where citizens can buy insurance under the Affordable Care Act, and replace it with a private enrollment system.

As a result, about 60,000 people in the state are likely to lose health insurance.

The scheme, which will affect people shopping for insurance in the fall 2022 enrollment period, was approved by the Centers for Medicare & Medicaid Services (CMS), which, despite widespread opposition, is encouraging other states to follow suit.

“I am a doctor, and I hear about my patients’ struggles to get good health insurance coverage every day,” an Atlanta physician wrote the CMS. “. . .changing the way that Georgians enroll in health care will add even more barriers and make it harder for people to enroll.”

HHS Secretary Alex Azar and David Kautter, an assistant Treasurer secretary, encouraged states to apply for federal waivers for some of the requirements of the Affordable Care Act. Kautter, who looked the other way while his former employer Ernst & Young set up an illegal tax-shelter scheme, helped rewrite the rules for waivers so states could promote plans that don’t have some of the consumer protections required under the Affordable Care Act.

Kemp’s plan could play a role in which party ends up with a majority in the U.S. Senate as Georgia residents vote in the run-off elections in January.

High Numbers Without Insurance

Georgia, which has the third-highest rate of people without health insurance in our nation, used that waiver program to cut off access to HealthCare.Gov. When people use the web site, they have to say what state they live in to buy insurance, and people can only buy insurance through the site if they live in one of the states that use it. Thirteen other states have state-based marketplaces, but Georgia will be relying on private industry.

“Approval of the state’s waiver will usher in a groundswell of healthcare innovation that will deliver lower costs, better care, and more choice to Georgians in the individual market,” said Seema Verma, the administrator for the Centers for Medicare & Medicaid Services.

Critics have said the Georgia plan is illegal because the Affordable Care Act requires state waivers to not result in people losing coverage. The Supreme Court is scheduled to hear arguments Tuesday in a case brought by Republican state officials trying to destroy the Affordable Care Act.

Campaign Contributions

Kemp received $272,600 from the insurance industry in his 2018 campaign for governor.

Georgia claims it will be able to increase the number of people covered by insurance by 25,000 “through improved customer service, outreach, and education provided by the private market.”In the 2020 plan year, at least 16 insurers and web brokers sold on federal marketplace in Georgia.

Other states that changed how insurance was sold online for the Affordable Care Act had big drops. Kentucky’s marketplace enrollment fell 13% when it changed to the federal marketplace in 2017 compared to a 4% decline nationally. Nevada’s enrollment fell 7% for the 2020 plan year after it switched to a state-based marketplace, compared to flat enrollment nationally.

Similar declines in Georgia could mean 25,000 to 46,000 fewer people in marketplace enrollment. Many Georgians could also lose Medicaid coverage which they enroll in through HealthCare.gov. In 2020, at least 38,000 Georgians enrolled in Medicaid through the federal marketplace.

Kemp’s insurance initiative helps insurers who have a financial incentive to sell inadequate policies.

Short-term plans often pay higher commissions, up to 10 times as much as plans that follow the rules of the Affordable Care Act.  One of the most popular short-term plans in Atlanta offered no coverage of prescription drugs, mental health services or maternity care.