ATL Standard

A recent report by the Georgia Public Policy Foundation has examined the health insurance marketplace in Georgia since Governor Brian Kemp took office. The report highlights significant improvements in the state's health insurance landscape, which was described as "dire" when Kemp assumed office in 2019.

The analysis focuses on waivers submitted by Governor Kemp that established both Georgia’s reinsurance program and a state-based exchange called Georgia Access, currently managed by Georgia Insurance Commissioner John King. According to the report, “other governors should emulate Kemp’s success if they wish to seize power back from Washington, D.C., bring revenue to their states and use the power of the private sector.”

In 2018, many Georgians faced challenges in obtaining individual health insurance due to a lack of insurers. Only four carriers operated on the individual market at that time, with 145 counties having just one insurer and 14 counties having two. This lack of competition led to higher insurance rates and lower reimbursement rates for providers.

Governor Kemp's 1332 waiver, approved in November 2020 and effective from January 1, 2022, through December 31, 2026, aimed to address these issues. Under this waiver, Georgia reimburses health insurers selling individual market plans for a percentage of claims above a certain amount. This approach helped control insurer costs and resulted in lower premiums.

The reinsurance program has had a notable impact on stabilizing and lowering premiums. In 2023, statewide premiums were reduced by 12.4%, while rural counties saw reductions as high as 34.3%. Additionally, increased competition among insurers further contributed to lower premiums.

As of now, only one county has as few as two carriers compared to the previous situation where many had just one or two options. Sixteen percent of counties now have at least three carriers; thirty-one percent have four; and over fifty-two percent have five or more carriers operating within them. The number of carriers participating in Georgia’s individual market rose from four in 2018 to ten in 2024.

Another significant accomplishment under the Kemp administration is the growth in enrollments in individual health insurance plans through Georgia Access. This state-based healthcare exchange leverages private-sector efficiencies to offer maximum choice to residents.

Since its establishment, enrollment numbers have surged from approximately 375,000 individuals enrolled in plans on the individual market in 2019 to about 1.3 million by 2024—a gain of nearly one million people or about nine percent of Georgia's total population.

Overall premium reductions for individual market plans during Kemp’s tenure reached twelve percent statewide and up to thirty percent in rural areas. These developments position Georgia as a model for other states seeking similar reforms.

The report concludes that adopting similar strategies could help other states reclaim authority from federal oversight while enhancing their healthcare systems through private sector involvement.

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