CMS approves Georgia's insurance waiver: 4 things to know

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On Nov. 1, CMS approved Georgia's request to implement a waiver that will change how the state runs its individual marketplace.

Four things to know:

1. The waiver will be implemented in two phases. The first phase is the creation of a reinsurance program in 2022. A reinsurance program is a reimbursement system that aims to shield health insurers from high claims. CMS estimates the program will reduce annual premiums in Georgia's individual market by an average of 10 percent.

2. Phase two includes moving the state's individual market from the exchange that the federal government runs, HealthCare.gov, to a private sector platform called the Georgia Access Model. That transition will be effective for the 2023 plan year.

3. CMS said increasing traffic to private brokers, health insurers and agents will incentivize these entities to increase their outreach to Georgia's uninsured population. Critics say the move could be confusing for residents, and could lead to thousands losing insurance. Georgia has one of the nation's largest uninsured rates at 13.7 percent. 

4. The decision comes less than a month after Georgia won approval for its Medicaid section 1115 demonstration Oct. 15. Under the "Pathways to Coverage" demonstration, residents who make less than the federal poverty level qualify for Medicaid if they record at least 80 hours of work, volunteering or education per month.

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