Trump Admin’s Approval of Georgia’s Section 1332 Waiver Will Decrease Enrollment by up to 100k, Direct Georgians to Junk Insurance Plans, and Raise Premiums

Waiver Approval Unlawfully Allows State to Eliminate Use of Online Marketplace

Washington, D.C. — Today, Planned Parenthood Southeast and Feminist Women’s Health Center, represented by Democracy Forward, sued Trump’s Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS), among others, for unlawfully approving the State of Georgia’s plan to ignore essential Affordable Care Act (ACA) requirements and block Georgia residents’ access to Up to 100,000 Georgians stand to lose their insurance as a result of the plan, which the Trump administration approved via a “Section 1332” waiver of ACA requirements. The plan will do immense damage to Georgia’s health insurance market, force Georgians to shop for insurance through private brokers and insurance companies, lead more residents to enroll in junk plans, and increase premiums. The plaintiffs’ lawsuit seeks to vacate the Trump administration’s unlawful approval of Georgia’s Section 1332 waiver and a 2018 Trump administration decision that provided the basis for the waiver approval.

“More than 100,000 Georgians stand to lose their insurance if this waiver is allowed to stand. This is unacceptable at any time, but in the middle of a global pandemic, it is unconscionable,” said Planned Parenthood Southeast President and CEO Staci Fox.  “As a provider of reproductive and sexual health care, we know firsthand how critical the ACA has been to expanding access to care. We will do everything in our power to protect that care for the thousands of Georgians who count on it. Whether the attacks are coming from the White House or the State House, we will not back down.”

“At Feminist Women’s Health Center, we deeply believe that health care is a human right. The current ongoing pandemic has brought more keenly into focus the vast disparities that exist in access to care and amplified the need to remove the obstacles people are facing to be well,” said Feminist Women’s Health Center Executive Director Kwajelyn J. Jackson. “Georgia doesn’t need to make health care access, particularly reproductive health care, even more complicated and out of reach for thousands in Georgia.”

“The Trump administration’s approval of Georgia’s Section 1332 waiver turns back the clock for Georgians trying to enroll in quality health care to the time before the Affordable Care Act was passed — when consumers were forced to navigate a thicket of private insurers and brokers to get covered,” said Democracy Forward Senior Counsel John Lewis. “Unfortunately for the outgoing administration, the ACA is still the law of the land, and this latest attempt to sabotage its core pillars will fail.”

Nearly 80% of Georgia residents who enroll on the individual market find and purchase their health coverage on But, on November 1, 2020, the Trump administration unlawfully approved Georgia’s Section 1332 waiver request, which will terminate the state’s use of or any other centralized marketplace.

In order to grant states flexibility to innovate in ensuring their residents are able to obtain affordable, high-quality health insurance, Section 1332 of the ACA allows the federal government to grant states waivers of some ACA requirements — but only if states demonstrate that their plans match or surpass the ACA’s benchmarks with respect to coverage, comprehensiveness, affordability, and deficit neutrality.

The approval of Georgia’s unlawful waiver takes a wrecking ball to the ACA in Georgia and violates the statutory guardrails designed to ensure that Section 1332 waivers match or surpass the ACA’s benchmarks. Georgia’s waiver will:

  • Decrease enrollment by up to 100,000, violating the coverage guardrail;

  • Shift consumers to junk plans that provide inadequate coverage, violating the comprehensiveness guardrail;

  • Increase the premiums consumers must pay to receive coverage, violating the affordability and the deficit neutrality guardrails.

HHS’s approval of Georgia’s extraordinary waiver request was rushed through in the last months of President Trump’s term with a limited public comment period, in violation of the Administrative Procedure Act. Of the 1,826 total comments HHS received on the waiver, only 8 supported the waiver.

HHS’s decision to approve Georgia’s waiver request depended on 2018 guidance it promulgated, which substantially weakened the standards for approving waivers under Section 1332. The guidance thereby encouraged state plans — like Georgia’s — that will drive consumers to junk plans that fall short of the ACA’s coverage requirements.

The Trump administration’s rushed approval of Georgia’s unlawful waiver is consistent with its endeavor to sabotage the Affordable Care Act. For years, President Trump promised to decimate the Affordable Care Act. His administration has made good on that promise by promoting junk plans, slashing the open enrollment period and funding for outreach and navigators, and rolling back key protections enshrined by the law.

Democracy Forward filed the lawsuit on behalf of Planned Parenthood Southeast and Feminist Women’s Health Center on January 14 in the U.S. District Court for the District of Columbia. Read the complaint in full here.


Democracy Forward is a nonprofit legal organization that scrutinizes Executive Branch activity across policy areas, represents clients in litigation to challenge unlawful actions, and educates the public when the White House or federal agencies break the law.

Planned Parenthood Southeast believes in the fundamental right of each individual to manage their fertility, regardless of the individual’s income, marital status, race, ethnicity, gender identity or expression, sexual orientation, age, religion, disability, or residence.

Feminist Women’s Health Center provides safe, affordable, and compassionate abortion and gynecological care to all who need it without judgment. FWHC is the only non-profit, locally-based organization in Georgia that directly provides reproductive health services, while also protecting reproductive rights and promoting reproductive justice through organizing and advocacy.

Press Contacts

Charisma Troiano
Democracy Forward
(202) 701-1781

Barbara Ann Luttrell
Planned Parenthood Southeast

Megan Gordon-Kane
Feminist Women’s Health Center