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Georgia health insurance exchange

'Peach State' opts for HealthCare.gov, 316,000 enroll in QHPs

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Obamacare enrollment in Georgia has ended for 2014. However, people who get married or divorced, change jobs, have a child or experience another qualifying event may be eligible for a special enrollment period. Enrollment for Medicaid and the Children’s Health Insurance Program (CHIP) continues throughout the year. Individuals who don’t have health insurance that provides “minimum essential coverage” may have to pay a penalty: $95 or one percent of income, whichever is greater.

Open enrollment for 2015 coverage through the marketplace begins Nov. 15.

Signups for qualified health plans (QHPs) in Georgia grew 127 percent — from 139,371 as of March 1 to 316,543 — in the final weeks of 2014 open enrollment. While Georgia is not expanding its Medicaid program, 91,914 people who visited the marketplace qualified for either Medicaid or the Children’s Health Insurance Program (CHIP) under existing eligibility criteria.

Among Georgia residents selecting a QHP, 87 percent qualified for financial assistance, compared to 85 percent nationally. A report released in June by the U.S. Department of Health and Human Services showed the average monthly premium, after tax credits, for Georgia consumers was $54. Sixty percent of enrollees pay $50 or less per month after subsidies. Georgia’s $54 average is second only to Mississippi, where the average monthly premium after subsidies is just $23.

Ten percent of Georgia residents selected a bronze plan (20 percent nationally), 73 percent selected a silver plan (65 percent nationally), 6 percent selected a gold plan (9 percent nationally), 9 percent selected a platinum plan (5 percent nationally) and 2 percent selected a catastrophic plan (2 percent nationally). Thirty-one percent of Georgia enrollees were between the ages of 18 and 34.

Georgia is among the 26 states that opted to use the federal health insurance marketplace, HealthCare.gov. State government officials such as Gov. Nathan Deal and Insurance Commissioner Ralph Hudgens continue to speak out against the marketplace. In his 2014 State of the State address, Deal called the Affordable Care Act “anything but affordable.” Hudgens implemented a requirement that navigators, who help consumers use the marketplace, pass the test that insurance agents are required to take. That requirement is much more stringent than required by the health care reform law, and Hudgens openly stated it was intended as obstructionism. At the end of its 2014 session, the Georgia Assembly passed a bill that prohibits establishing a state-run marketplace, disallows the use of taxpayer money for navigator programs, and forbids government employees from advocating for Medicaid expansion.

Georgia is also among that states that rejected an expansion of the Medicaid program. While Deal has repeatedly said Medicaid expansion would cost the state too much, his administration did show some signs that it may reconsider. In particular, an advisor to Deal expressed interest in the “premium assistance” option, which uses Medicaid funding to enable low-income residents to purchase private insurance through the marketplace. The General Assembly responded by passing a bill that gives it authority over any changes to the state’s Medicaid rules. By not expanding Medicaid, the state is leaving up to 650,000 low-income residents in a coverage gap — unable to qualify for either Medicaid or subsidies through the marketplace.

Georgia health insurance exchange links

HealthCare.gov
800-318-2596

Georgia Watch
866-339-2824

State Exchange Profile: Georgia
The Henry J. Kaiser Family Foundation overview of Georgia’s progress toward creating a state health insurance exchange.