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Georgia Health Exchange Profile


Establishing the Exchange

On November 16, 2012, Governor Nathan Deal (R) announced that the Georgia had stopped planning for an exchange. 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. The 25-member Committee included state officials, insurers, brokers, business representatives, consumers, and providers. 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. 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.

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.

Exchange Funding

The Georgia State Office of Planning and Budget received a federal Exchange Planning grant of $1 million in 2010.

Next Steps

The federal government will assume full responsibility for running a health insurance exchange in Georgia beginning in 2014.

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