1. Executive Summary

Comprehensive Free Market
Health Insurance Reform for Georgia


In June 2012, the United State Supreme Court ruled the national health reform legislation (PPACA) is unconstitutional. Now, the major responsibility for health insurance reform falls to states.  The Georgia Public Policy Foundation facilitated a multi-stakeholder discussion and the development of Comprehensive Health Insurance Reform for Georgia.      


Following basic principles and beliefs in (1) Free Markets, (2) Personal Responsibility, (3)Competition, (4) Choice, (5) Transparency, and (6) a Level Playing Field for all – recommendations are made for three major areas of reform to be pursued simultaneously:


1.      Restructure the insurance market to increase competition, transparency, access, and portability
         (See Sample Legislation)  (FAQ)
2.      Strengthen the free-market safety net to keep existing policyholders from losing coverage
         (See Sample Legislation)   (FAQ)
3.      Make health insurance more affordable for individuals and small businesses
         (See Sample Legislation)   (FAQ)


Restructure Insurance Market – “Four Pillars” of reform include:

a.       Competition – develop a multi-state regional insurance information market and interstate reciprocity
         (Sample Legislation)
b.      Transparency – encourage the development of private Health Insurance Information Marketplaces
         (Sample Legislation) 
c.       Access – create a Personal Responsibility High Risk Pool
         (Sample Legislation)   (FAQ)

d.      Portability – create a Group Conversion option for portability and consistency of group insurance services  


Strengthen the Free-Market Safety Net 

  1. COBRA – add an HSA eligible plan under COBRA options
  2. Continuation of Coverage – equalize small group with larger group COBRA options
  3. Pre-existing Conditions – equalize insured and self-insured pre-existing standards
  4. Dependent Children – provide coverage for tax dependents to age 26
  5. Rescissions – only for fraud and intentional misrepresentation
  6. Uninsureds – support and expand Georgia Charity Care Network (Sample Legisaltion)

 Make Heath Insurance More Affordable

  1. Allow Defined Contribution plans with HRAs for employer contributions
  2. Allow Individual insurance purchases using Sec 125 for employee contributions
  3. Allow Financial Incentives – remove application of rebate laws for health compliance
  4. Allow Exclusive Provider Networks
  5. Expand physician choice with “Any Willing Provider” law
  6. Remove Premium Taxes for Comprehensive Medical plans
  7. Allow State income Tax Deduction for Comprehensive Medical plans


In summary, the 2013 Georgia General Assembly should pass legislation incorporating these free-market solutions that provide:

  1. Unique “Georgia Solutions”,
  2. Four “Game Changing” Pillars to Restructure the Marketplace,
  3. More than 30+ Supporting Recommendations to promote transparency, health literacy, access to insurance, portability, strengthening the free market safety net, and lower premiums.
  4. Specific Insurance Laws & Regulatory Improvements, and
  5. Recommendations that Meet Governor Deal’s Guiding Principles for insurance reforms that make insurance more affordable for individuals and small groups and support his initiatives for economic growth.