georgia guide to health insurance

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Georgia health insurance exchange

More competition across Georgia

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Georgia consumers shopping for health insurance on the marketplace have nearly double the number of insurers to choose from in 2015 as they did in 2014. In addition, three companies — as opposed to one last year — are selling policies statewide. A health insurance expert at Georgia State University says the influx of statewide competition will help reduce disparity in premium costs seen among different regions of the state.

Healthcare.gov — which Georgia consumers use to enroll — has been revamped since last year’s difficult rollout. HealthCare.gov 2.0 is faster, handles more users, and is more secure against hackers. Consumers can now “window shop,” so they can compare options without logging in. Another positive change is a much shorter application for first-time shoppers: 16 screens vs. 76.

Early reports on HealthCare.gov’s performance are mostly positive. About 1 million people visited HealthCare.gov and about 200,000 called the call center on the first weekend of open enrollment. Officials did not release how many people actually completed the enrollment process.

2015 open enrollment started Nov. 15 and continues until Feb. 15. Consumers need to sign up or re-enroll by Dec. 15 to have coverage on Jan. 1.

Take action

If you bought a marketplace plan last year, you may have heard that your policy will automatically renew for 2015. Even if you qualify for auto-renewal, it’s better to visit HealthCare.gov and check out your options for 2015. With new insurers entering the market, returning insurers changing their plans and prices, and the likelihood that you’ll qualify for a different subsidy amount in 2015, you may find a new plan will cost you less than sticking with your old plan.

More choices for consumers

Nine insurers are participating in the Georgia health insurance marketplace for 2015, including four who are new to the exchange this year. The returning companies are Alliant Health Plans, Blue Cross, Humana, Kaiser Permanente, and Peach State Health Plans. The new entrants to the marketplace are Cigna, Coventry, UnitedHealthcare, and Time Insurance.

2015 premiums up less than 4 percent

According to PricewaterhouseCoopers, premiums will increase an average of 3.7 percent, with a range of 7.1 percent lower to 18.3 percent higher. The figures are for plans sold both on and outside the exchange.

Given that southern Georgia had some of the highest premium costs in the nation for 2014, the modest average increase is welcome news for the second year of Obamacare.

Need help enrolling?

Navigators provide face-to-face assistance to help consumers understand their options and get signed up for health insurance. According to Enroll America, consumers who got one-on-one help in 2014 were nearly twice as likely to enroll successfully as those who tried on their own.

Contact Structured Employment Economic Development Corporation (visit SEEDCO.org or call 855.899.6092) or Community Health Works (visit chwg.org or call 478.254.5211) to get connected with a navigator.

Facts and figures from 2014 enrollment

More than 316,500 Georgians enrolled in qualified health plans (QHPs) during 2014 open enrollment. That’s nearly 30 percent of the estimated 1,063,000 Georgians considered eligible to enroll in the insurance marketplace by the Kaiser Family Foundation.

Among Georgia residents selecting a QHP, 87 percent qualified for financial assistance, compared to 85 percent nationally. A report released in June 2014 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 the second-lowest in the nation — after 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.

Background on the marketplace in Georgia

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 vocally oppose the Affordable Care Act. 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’s director of Enroll America, Dante McKay, said that lack of access to navigators hurt enrollment in rural Georgia counties in 2014. McKay also said the amount of federal funding Georgia received for navigators was among the lowest of all the states on a per uninsured basis in 2013 — and the amount decreased in 2014.

Georgia also 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 bills that give it authority over any changes to the state’s Medicaid rules. By not expanding Medicaid, the state is leaving up to 282,000 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

Georgia Health News