Georgia Section 1332 State Innovation Waiver Amendment

The State of Georgia is seeking federal approval to amend its existing Section 1332 State Innovation Waiver. 

OCI is accepting public comments on the proposed amendment from October 13, 2026 through November 13, 2026. Members of the public may review the draft amendment, attend a virtual public hearing, and submit comments online or by email.

Review the Draft Amendment  (PDF, 3.79 MB)
Submit a Public Comment

What is a Section 1332 waiver?

Section 1332 of the Affordable Care Act allows a state to request approval to change how certain marketplace and financial assistance rules operate within that state. A waiver gives a Georgia the flexibility to design a Georgia-specific approach as long as it continues to meet federal consumer-protection and budget standards.

To receive approval, a Section 1332 waiver must demonstrate that the state's approach will:

  • Provide coverage that is at least as comprehensive as coverage available without the waiver.
  • Provide coverage and cost-sharing protections that are at least as affordable as they would be without the waiver.
  • Provide coverage to at least a comparable number of residents.
  • Not increase the federal deficit.

The U.S. Departments of Health and Human Services and the Treasury review Section 1332 waiver applications and determine whether a state proposal meets these requirements.

About Georgia's proposed amendment

Georgia currently operates an approved Section 1332 waiver that supports the State's reinsurance program. OCI is proposing an amendment to that waiver for plan years 2028 through 2031 that would make additional changes to how financial assistance and consumer support operate through Georgia Access. The existing reinsurance program will continue.

The full program design, eligibility rules, financial projections, and implementation details are available in the draft waiver amendment and supporting actuarial and economic analysis.

Review the proposed waiver amendment

The materials below provide additional information about Georgia's proposed Section 1332 waiver amendment and the analyses supporting the proposal.

Section 1332 Waiver Amendment  (PDF, 3.79 MB)
Actuarial and Economic Analysis  (PDF, 3.43 MB)
Public Notice  (PDF, 258.64 KB)
Letter of Intent  (PDF, 715.32 KB)

Virtual public hearings

OCI will hold two virtual public hearings during the public comment period. The hearings will provide an overview of the proposed waiver amendment and an opportunity for members of the public to provide oral comments.

Public Hearing 1
Thursday, October 15, 2026, 12:00 p.m. - 1:00 p.m. Eastern Time
Format: Virtual
Virtual Access: Meeting Link. Password: qy6pL2W8

Public Hearing 2
Tuesday, October 27, 2026, 5:00 p.m. - 6:00 p.m. Eastern Time
Format: Virtual
Virtual Access: Meeting Link. Password: qy6pL2W8

Submit a public comment

OCI welcomes comments from individuals and organizations on the proposed Section 1332 waiver amendment. Comments will be accepted from October 13, 2026 through November 13, 2026.

You may submit a comment in any of the following ways:

  • Online: Use the public comment form linked below.
    Submit a Public Comment
  • Email: Send comments to the public comment email address below.
    [email protected]
  • Virtual hearing: Provide an oral comment during either virtual public hearing listed above.

Please note that comments will not be accepted after 11:59 PM ET on November 13, 2026.

Contact and accessibility

Questions or assistance
[email protected]
Individuals who need assistance accessing the waiver materials or participating in a virtual hearing may contact OCI using the information above.