On Monday, the 1.3 million Georgians who bought health insurance on the Affordable Care Act marketplace exchange, also known as Obamacare, can start window shopping for next year’s policy. But for the first time since the ACA went live over a decade ago, they will be blocked from doing so on the federal website healthcare.gov.
Instead, Georgia is launching its own marketplace for 2025 coverage: GeorgiaAccess.gov. Open enrollment begins Friday.
The state says it’s offering new opportunities for Georgia’s ACA consumers to have a smooth shopping experience and more choices. Some fear it also offers risks, as private businesses that seek to profit from commissions might get more involved in enrolling people under the Georgia system than they did in the federal system.
And, crucially, the state also has begun reaping the hundreds of millions of dollars that flow from user fees charged anytime policyholders enroll on the site. The fees used to go to healthcare.gov. That won’t change rates for consumers; plans and federal subsidies will remain the same.
“Georgians have a true no-wrong-door approach for enrolling in coverage,” the office of the Georgia Commissioner of Insurance, John King, said in a written announcement.
By law, the GeorgiaAccess.gov consumer portal should allow Georgians to do what they did on healthcare.gov: compare and contrast the options available to them, by price and level of coverage, without getting hoodwinked by cheap but weak policies that don’t cover basic needs.
Georgia has taken action to do that. Georgia Access, as the state’s new ACA office is called, has hired a contractor and leaders with deep experience in running ACA exchanges in other states. An early look they provided The Atlanta Journal-Constitution shows the GeorgiaAccess.gov consumer portal’s comparisons appear as clear as the feds’, and the site also makes it easy to look at which plans cover consumers’ local hospitals.
But there will be new features.
Before GeorgiaAccess.gov shoppers ever enter that consumer portal, which is the state’s shopping site, they will have the option to choose a different way to shop. GeorgiaAccess.gov has prominent links to funnel shoppers to private web brokers and insurance agents, if they click.
The focus on private web brokers makes the Georgia site unique among more than a dozen state-based exchanges. State officials say private businesses will help Georgia shoppers, and they point out that many Georgians already were using those options on their own anyway.
State officials say they are prepared to take action and even revoke agents’ licenses if they’re not acting in the consumers’ best interests.
“Let's say there is an agent who has been appointed to sell every health plan on the exchange. However, this agent only promotes to consumers the health plan with the highest commission. Georgia Access has the ability to suspend that agent from the platform and perform an investigation. If the investigation found that the agent was not acting in the consumer's best interests and was only promoting that plan to obtain the high commission, Georgia Access would revoke that agent's license, and refer that agent to OCI enforcement for additional administrative review and potential action."
“Are we doing something that’s a little bit new? Yeah, we are,” said Cheryl Gardner, executive director of Georgia Access. “But we’re doing that in the interest of our consumers. Consumers told us what they wanted, and we listened and we responded.”
Private web brokers have a mixed reputation.
Two of the web brokers Georgia currently is working with, Benefitalign and Inshura, have been temporarily banned by the federal healthcare.gov website and are being sued for allegedly “swapping” people into poor coverage in order to get new commissions, and exporting their personal data to a foreign country. The companies have denied wrongdoing. Gardner said Georgia was tracking the situation.
Other web brokers have good reviews from patient advocates. HealthSherpa.com exposes shoppers only to health plans that meet federal requirements for covering essential health benefits and other needs. Among this year’s 1.3 million ACA policyholders in Georgia, about 550,000 enrolled on healthsherpa.com. They can still do that for next year.
Navigators still available
Georgia shoppers will still have unbiased “navigators,” paid to help them understand the shopping website and their options, just as they had under healthcare.gov. Navigators are government-funded, not paid by commission. They are trained to help people even if it turns out they might be better off with a Medicaid plan, the free government health care for some low-income adults.
Georgians will have more navigators standing by than they did under the federal website, Georgia Access officials said. They are available through the state’s main help phone line, 1-888-687-1503. The federal 800 number, like healthcare.gov, will not help Georgians with 2025 coverage, only current coverage for 2024.
Georgians for a Healthy Future, a policy nonprofit, won a $1 million grant to provide navigators. It also is distributing information on the program through a statewide network of YMCAs.
Colbert said GHF was “cautiously optimistic.”
courtesy
courtesy
Whitney Griggs, who works on policy for GHF, said she hopes all Georgians can get unbiased help anywhere they shop.
“We don’t know how they’re going to play out in real time,” Griggs said.
State officials said they’re doing their best not only to protect consumers but also to improve their experience, and to make sure this won’t be a repeat of the long-ago famous meltdown healthcare.gov had when it first launched a decade ago.
“Anytime you have a big launch like this, you’re going to have some unexpected situations arise,” Gardner said. “But we think what we don’t have is a failure to imagine. We have imagined just about anything that can come up, and we are prepared to deal with it.”
2025 ACA PLANS: SHOPPING BEGINS
Georgia’s 1.3 million residents on Affordable Care Act health insurance will have a new home base for 2025 coverage, Georgia Access. Here are some tips.
- Window shopping begins Monday. Open enrollment beginsFriday.
- All 1.3 million Georgia policy accounts have been transferred from the federal exchange to the state exchange, no matter how they enrolled. If the policyholders do nothing, they will be automatically reenrolled in the same or similar plan for 2025 coverage.
WHERE TO SHOP
- Georgians cannot shop Healthcare.gov for 2025 coverage. They can still use Healthcare.gov for remaining 2024 coverage.
- The new ACA website for Georgians will be GeorgiaAccess.gov. Click “Consumer Portal” for the state’s site to shop, contrast and compare plans and prices for your income situation.
- Unbiased “navigators” are available. The state’s help line is 888-687-1503 (TTY Line 711).
- The web broker HealthSherpa.com presents only plans that meet the federally qualified guidelines for robust coverage. Its phone number is (855) 772-2663.
- GeorgiaAccess.gov also suggests using private agents, insurance company websites and other web brokers for help. They can be searched from the website.
Sources: Georgia Office of the Commissioner of Insurance Safety Fire; HealthSherpa.com; U.S. Centers for Medicare and Medicaid Services.
About the Author
