Supporters of the waiver plan said it would produce more options for Georgians. That should mean more health insurance plans to choose from, said Chris Denson, director of policy and research at the Georgia Public Policy Foundation, a libertarian-leaning think tank. “The state received approval from (the federal government in 2020) to proceed with the implementation,” and the Biden administration has no authority to undo that, Denson said.

Opponents of the Kemp plan say that on the contrary, research shows that both private companies and private insurance agencies instead try first and foremost to make the biggest profit they can. They say studies show a history of selling consumers plans that don’t meet their needs the best.

“Governor Kemp’s plan to shut down the most popular enrollment pathway for Georgians buying their own health insurance is a gamble,” betting that people won’t give up on shopping for insurance entirely, said Laura Colbert, director of Georgians for a Healthy Future, an organization that supports the ACA and Medicaid expansion.

The waiver was approved by the Trump administration two days before the 2020 election, which left the waiver’s implementation to the Biden administration. Knowing that if Trump lost the election a Biden administration would likely look askance at the proposal, Trump aides changed its standard contract to make it harder for any future administration to revoke the waiver.

Indeed, the letter from Kemp’s office is the latest salvo in a battle between the Kemp administration and the Biden administration over Kemp’s health care waiver proposals. Rather than providing a “corrective action plan” as Washington had demanded, Kemp’s office instead pushed back in the letter and said Washington was just trying to stop the proposal. The standoff virtually assures that the battle will wind up in court.

Colbert said that the plan the feds requested “simply asked that Georgia better detail its ‘outreach and communications plan, including planned funding, a spend plan, and additional information on engagement with underserved communities.’” but that Georgia had refused to do that. “After spending $31 million and ‘thousands of hours of staff time’ on the planning and implementation of Governor Kemp’s signature health care policy, surely the state has these plans in place already and the plans would be easy to share.”

The Georgia letter countered that the Biden administration has asked for data that would be impossible to produce within the time frame it demanded.

Kemp’s director of health strategy and coordination, Grant Thomas, signed the letter. He did not specify what the $31 million had been spent on.

A spokesman for Kemp, Andrew Isenhour, also did not list out expenditures. But he said that the money included both state and federal dollars, and was spent on “technical system needs and digital architecture services, consulting and project management services, a public awareness campaign, and general program consulting support.”

The Georgia letter said the numbers speak for themselves.

“For many Georgians, HealthCare.gov is difficult to navigate. That is why, despite offering billions in federal premium tax credits over the years for people seeking insurance through that portal, almost one million Georgians eligible for subsidies remained uninsured.”

The number of uninsured who are eligible for subsidized ACA plans is now just over half a million. Anyone can buy a plan under the ACA, but federal subsidies are available subject to income limitations.

Laura Harker, a senior policy analyst at the left-leaning Georgia-based Center on Budget and Policy Priorities, argued that people instead remain uninsured for a variety of reasons, including that the deductibles may be too high or they can’t afford even the subsidized premiums.

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