State Exchange Profiles: Georgia
Updated as of December 11, 2012
Establishing the Exchange
On November 16, 2012, Governor Nathan Deal (R) announced that the Georgia had stopped planning for an exchange.1 In the previous year Governor Deal issued an Executive Order to create the Georgia Health Exchange Advisory Committee to assess whether and how Georgia should establish a health benefit exchange.2 The 25-member Committee included state officials, insurers, brokers, business representatives, consumers, and providers.3 The Committee also formed subgroups to develop recommendations on governance, operations and finance, and insurance markets. In October 2011, the subgroups released reports that included recommendations to establish a ‘Georgia Health Insurance Marketplace Authority’ as a quasi-governmental, non-profit corporation with a single governing body that maintains two separate risk pools for businesses and individual consumers.4,5,6 In December 2011, the Committee submitted final recommendations to the Governor in support of creating a small business health insurance marketplace through a wholly private or limited quasi-governmental entity, but did not commit to building an individual exchange.7
Essential Health Benefits (EHB): The ACA requires that all non-grandfathered individual and small-group plans sold in a state, including those offered through the Exchange, cover certain defined health benefits. Since Georgia did not put forward a recommendation, the state’s benchmark EHB plan will default to the largest small-group plan in the state, Blue Cross Blue Shield of Georgia- HMO Urgent Care 60 Copay.
The Georgia State Office of Planning and Budget received a federal Exchange Planning grant of $1 million in 2010.
The federal government will assume full responsibility for running a health insurance exchange in Georgia beginning in 2014.
1. Press release from Governor Nathan Deal. “Georgia Will Not Set Up Exchange.” November 16, 2012.http://gov.georgia.gov/press-releases/2012-11-16/deal-georgia-will-not-set-state-exchange
2. Executive Order issued on June 2, 2011.http://gov.georgia.gov/vgn/images/portal/cit_1210/21/41/17217485106_02_11_01.pdf
3. Georgia’s 2011 Health Insurance Exchange Advisory Committee Appointees.http://healthcarereform.georgia.gov/vgn/images/portal/cit_1210/15/45/173596255Advisory%20Committee%20Appointees%20-%20Updated%20072111.pdf
4. Georgia Health Insurance Exchange Advisory Committee Governance Subcommittee Presentation. October 27, 2011.http://healthcarereform.georgia.gov/vgn/images/portal/cit_1210/42/42/178821132Governance%20Subcommittee%20Presentation.pdf
5. Insurance Markets Subcommittee Report for the Georgia Health Insurance Exchange Advisory Committee. October 27, 2011.http://healthcarereform.georgia.gov/vgn/images/portal/cit_1210/42/41/178821134Insurance%20Markets%20Subcommittee%20Report.pdf
6. Health Insurance Exchange Advisory Committee Operations and Finance Subcommittee. October 27, 2011.http://healthcarereform.georgia.gov/vgn/images/portal/cit_1210/42/40/178821136Operations%20%20Finance%20Subcommittee%20Report.pdf
7. Report to the Governor. Georgia Health Insurance Exchange Advisory Committee. December 15, 2011.http://healthcarereform.georgia.gov/vgn/images/portal/cit_1210/28/4/179765813GHIX%20Final%20Report%20to%20the%20Governor.pdf