Democratic challengers say Georgia commissioner should do more to hold insurers accountable

No Georgia official is more directly tied to affordability than the state’s commissioner of insurance. And that job is on the ballot this year, starting with Tuesday’s primary.

The commissioner’s main job is to make sure Georgia insurance companies don’t charge policyholders too much for their coverage like health and auto policies. And that after the consumer pays their premiums, the companies cover what they’re supposed to.  

The field to unseat the incumbent, Republican John King, is packed with five Democratic challengers. Those who answered questions for this story say King is not doing enough, and they’ll do more. On the Republican ballot, King stands unchallenged and points to his record of levying millions in fines to the companies.

The Democratic contenders include Clarence Blalock, a Paulding County business owner; Ambuj “A.J.” Jain, former chief underwriting officer at an insurance company; DeAndre Mathis, an insurance agent with degrees in accounting; and Keisha Sean Waites, a former Georgia state representative and well-known candidate in elections across the Atlanta area. The candidates with insurance experience say they’re the ones who know how to stop insurance companies from gaming consumers.

A fifth candidate, Thomas Gabriel Dean, did not provide contact information to the state. Calls to a phone number associated with his name were not returned, and at a visit to a Stone Mountain address associated with his name, neighbors said Dean kept to himself.

“This race may not receive the same attention as contests for Governor or U.S. Senate, but its consequences are deeply personal and financial for Georgia families,” Laura Colbert, executive director of Georgians for a Healthy Future, said in a written statement. “The next Insurance Commissioner will help shape how much Georgians pay for coverage, what protections they can rely on when care is denied, and whether consumers have a strong advocate when insurers fall short.”

The position is titled the commissioner of insurance and safety fire. It’s elected statewide. Duties also include investigating complaints, inspecting elevators and others. 

One of its main initiatives in recent years was creating Georgia’s Obamacare marketplace, a state-run system for the Affordable Care Act exchange in Georgia. It’s called Georgia Access. Rather than skimping, King’s office hired a company well known for working with ACA-friendly states to create competent systems. At the same time, he has worked to distance himself and the state from the Obamacare label.

One facet that made GeorgiaAccess.gov distinct from the federal healthcare.gov is its more prominent platforming of private insurance agents as opposed to neutral “navigators” to consumers trying to choose a plan. Insurance agents are incentivized by commissions paid by companies. In any case, navigator funding has been slashed by the federal government under the Trump administration.

King argues he’s set the standard for using the office to protect consumers. All while facing state laws that he says tamp his power.

“I have issued a record number, and record amount, of fines since becoming Insurance Commissioner, to the tune of more than $42 million,” King said in a written statement. “We need to be able to do more, but the truth is that the Insurance Commissioner’s office is extremely limited when it comes to the fines we can issue. We fought to change that this year but it went nowhere in the Senate. That’s not going to stop me though. I’ll continue fining insurance companies as much as I can and I’m going to make another push for more oversight next year.”

When an insurance company files their proposed rate plans for the coming year, it’s up to the Office of the Commissioner of Insurance to vet the proposals. It determines whether the plans have enough doctors and hospitals in a plan’s network. The rates must not be “excessive,” according to state law.

That’s not always easily determined, especially when hospitals are charging record rates and hurricanes threaten billions in damage that home insurers might have to pay for, like Helene narrowly missing Atlanta in 2024.

Like other advocates who responded to the Georgia Recorder’s questions, Georgians for a Healthy Future said they do not take a position on candidates. GHF is a patient advocacy organization that helps people enroll in Georgia’s Obamacare exchange, Georgia Access, and has argued for full Medicaid expansion.

But those advocacy organizations also made pointed comments on what the job ought to do, calling for “independent leadership” willing to prioritize consumers over the insurance industry when they conflict.

“I just want that person to enforce the laws that we have on the books,” said Jonathan Marquess, a longtime leader of independent pharmacists and interim president of the Georgia Pharmacy Association.  

Independent pharmacies in Georgia have long complained that health insurance companies in Georgia get away with underpaying independent pharmacies and overpaying their own business partners, eventually costing patients more overall.

Roland Behm is co-founder of the Georgia Mental Health Policy Partnership and past chair of the Georgia chapter of the American Foundation for Suicide Prevention. Behm said that the state’s new law mandating the same level of coverage for mental health as for physical health was not being adequately enforced. 

“For a large insurance company, a $1 million fine is not a serious deterrent. It is a modest cost of doing business,” Behm said. “A penalty that does not compensate patients, change insurer behavior or force the use of lawful medical standards is not enough. It may be enforcement theater.”

The CEO of the Georgia Association of Health Plans, Jesse Weathington, said in a text message that the association doesn’t endorse candidates, and did not address policy questions.