November Medicare Updates: What Changes Are Coming and How They Affect You

MJP –

Georgia residents enrolled in Medicare can expect notable changes to their health insurance options beginning in November, as the state is transitioning from the federal HealthCare.gov platform to a state-operated marketplace named Georgia Access. This shift marks a significant overhaul in how health insurance is managed in the state, aligning with the upcoming 2025 open enrollment period.

The new Georgia Access marketplace, set to launch on November 1, has been developed over the past three years as part of a broader initiative to reduce Georgia’s reliance on federal systems for health coverage. John F. King, Georgia’s Insurance and Safety Fire Commissioner, emphasized the significance of this transition, stating, “This milestone is the result of the extraordinary work our office has conducted over the past three years to move Georgia away from reliance on the federal government for health coverage.” He described the Georgia Access initiative as an “innovative” approach, being the first state-based exchange to partner with private sector companies for consumer enrollment.

King noted that this effort reflects the state’s commitment to expanding access to affordable, quality health coverage and reducing the uninsured population in Georgia.

The introduction of the Georgia Access marketplace is intended to offer state residents a more straightforward and accessible means of searching for and enrolling in health coverage plans. The platform will feature various agents and insurers, providing users with a comprehensive overview of available options.

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Governor Brian Kemp also highlighted the importance of this development in connecting Georgians with the health coverage they need. He remarked, “A state-based exchange will not only make the process for Georgians getting covered easier but will also increase their coverage options and our ability to promote quality and affordable health plans.”

Benefits of the new Georgia Access platform for Medicare users

Kemp has identified the creation of Georgia Access as a key initiative during his administration. The process was initiated with the signing of the Patients First Act in 2019, which laid the groundwork for establishing the new state-run marketplace. This legislation enabled Georgia to submit a waiver to the Centers for Medicare & Medicaid Services (CMS), seeking permission to develop innovative healthcare solutions tailored to the state’s needs.

At the time of the Patients First Act’s passage, more than 1.3 million Georgia residents were uninsured, and 118 of the state’s counties had only one insurance carrier available to them, according to data from the Office of Commissioner of Insurance and Safety Fire. This lack of options underscored the necessity for reform. The waiver, submitted by Georgia on November 1, 2020, was subsequently approved, allowing the state to implement a reinsurance program designed to lower premiums and facilitating the shift from the federal HealthCare.gov system to the Georgia Access platform.

The state anticipates that Georgia Access will attract more residents to sign up for health insurance, potentially increasing competition among insurers and thereby improving the range and quality of options available to Georgians.

This expectation is supported by experts like Alex Beene, a financial literacy instructor at the University of Tennessee at Martin. Beene observed that while changes to health insurance options can often be met with skepticism, the shift to Georgia Access is largely a technical adjustment rather than a fundamental change to coverage. He explained, “In the past, Georgia residents have had to use Healthcare.gov for the portal to access provider options in their state.

This change will move those features to a new platform, Georgia Access, that will show residents all health insurance options available to them, including pricing.”

For Medicare beneficiaries and others in Georgia, the new marketplace could offer tangible benefits by making it easier to compare health insurance plans.

The platform is designed to simplify the often complex process of selecting coverage by clearly presenting the pricing and benefits of different plans side by side. Beene further commented on the potential advantages of the new system, stating, “It makes pricing easier to compare, as well as the difference in benefits between plans. What can be a complicated process becomes less so for those shopping for options.”