Increased Competition in the Georgia Health Insurance Market

One of the effects of the Affordable Care Act had in Georgia was the reduction in competition. This happened for multiple reasons:

  1. Insurance carriers were trying to adjust to the new rules.
  2. The new rules made it too expensive for some insurance carriers to offer plans.
  3. It made PPO and NPOS network too expensive to offer on the individual market.
  4. Some insurance carriers wanted the dust to settle before they decided what to do.

Thankfully, it looks like the dust is starting to settle and many insurance carriers are going to reenter the Georgia market! However it is not a done deal yet and there are other still things up in the air.

Georgia’s Innovation Waiver “Pathways to Coverage”

Georgia filed a waiver under the Trump administration to create its own healthcare marketplace, make changes to Medicaid and to start its own reinsurance pool to keep prices down. It would also allow for more plan options and choices. The Trump administration approved the waiver but we are not sure what the Biden administration will do. The most controversial element of this plan is the decision to impose work requirements on Medicaid beneficiaries, this is not something the Biden administration are fond of.

The CMS and Georgia have been talking back and forth and Georgia’s worry is that their waiver will get revoked. In their response, Georgia health officials pushed back on CMS’ inquiry, asserting that the letter “came as a surprise’’ because it does not follow the approved waiver process. In response to the agency’s request for additional information, the state insurance department noted that the waiver’s approval has already encouraged five new carriers to enter Georgia’s market for the next plan year, and that “more than 20 private-sector organizations have collaborated with the state and have made their own investments.” This could easily escalate into a lawsuit if the federal government tries to take back the Georgia waiver.

New Carriers in the Georgia Health Insurance Market

As the response above mentioned, five new carriers have applied to enter the individual market in Georgia in 2022. Friday, UHC, Bright, Cigna and Aetna have applied to either reentering the Georgia market or come here for the first time. Some of these names are very recognizable while others are newcomers. We will have later posts highlighting the new insurance carriers like Bright and Friday. Some of these carriers will also be offering small group health insurance plans, like Friday! While these carriers are not yet approved, they each have operated under the ACA in other states and there is no reason for them to get denied in Georgia.

More competition is a good thing! Stiffer competition will drive costs down, increase network options and just give consumers more choice all around. We are also hopeful that with more competition, lower prices and Georgia’s own marketplace (eventually), that health insurance scams will be harder to pull off. We have a post details some of the scam methods that companies use to sell deficient health insurance products. However more choice will bring more confusion so there will be opportunities for unscrupulous companies to take advantage of. Of course you could always just call us and not have to worry about being ripped off!


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