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Georgia health insurance

State of incremental gains – uninsured rate down, still above average

Health-related issues such as public health, how many people have health insurance, and attitudes toward healthcare reform influence the attitudes people have about a state. Are you concerned by Georgia’s public health trends? Do you agree with the policy decisions related to Obamacare in Georgia? This summary of selected issues can help you decide.

Georgia health ratings

The state of Georgia has not fared particularly well in recent state health rankings, in part due to issues such lack of health insurance and poor dental healthcare.

The Peach State placed 46th in overall health among the 50 states and the District of Columbia in the 2015 Scorecard on State Health System Performance, dropping one position from 2014.

The state ranked in the bottom 20 percent on 12 of 44 measures, faring worst in terms of uninsured adults (46th) and adults who went without care in the past year because of cost (50th). If more than 1 million adults became insured and 86,268 fewer adults would go without needed healthcare because of cost, Georgia would improve to the level of the best-performing state. See Georgia’s scorecard for more details about its ranking on individual health indicators.

In the 2015 America’s Health Rankings, Georgia placed 40th, a two-spot slide from 38th in 2014. The state performed in the bottom 20 percent for 13 out of 39 core measures, including lack of health insurance, the number of dentists per 100,000 people, and clinical care (i.e., dentists, primary care physicians, birthweight and preventable hospitalizations).

While the data is not summarized into an overall score, the 2016 edition of Trust for America’s Health scores a range of individual public indicators; see Key Health Data About Georgia.

Finally, you can review county-by-county health rankings for Georgia from the Robert Wood Johnson Foundation and the Population Health Institute at the University of Wisconsin.

How has Obamacare helped Georgia?

Most states that have successfully reduced their uninsured population through the Affordable Care Act have implemented a state-run or partnership exchange and/or expanded Medicaid. Georgia has done none of these things, which is typically an indication of ACA opposition.

The state’s uninsured rate has seen moderate decline from 2013, just before Obamacare plans took effect, through 2015. The percentage of Georgia residents without health insurance dropped 5.5 percentage points from 21.4 to 15.9 percent. In the same timeframe, the nation’s uninsured rate went from 17.3 to 11.7 percent.

2017 exchange rates, health insurance carriers

Georgia’s exchange, like many nationwide, will include fewer carrier options for 2017. UnitedHealthcare, Cigna and Aetna will exit the state’s exchange at the end of 2016, and the following carriers will remain:

  • Blue Cross Blue Shield of Georgia – will offer exchange plan in every county in the state
  • Harken Health Insurance
  • Humana – will reduce coverage to Atlanta, Columbus, Macon and Savannah areas
  • Kaiser Permanente
  • Ambetter from Peach State Health Plan
  • Alliant

Proposed rate increases have been requested and range from 7.4 percent to 67.5 percent. Final rates will become available later this fall on or before 2017 open enrollment begins November 1.

Georgia enrollment in qualified health plans

Just more than 316,500 Georgia residents enrolled in qualified health plans (QHPs) during the 2014 open enrollment period. That’s 29.8 percent of eligible enrollees, above the national average of 28 percent. Of those enrolling in a QHP, 87 percent qualified for tax subsidies to make the premium cost more affordable.

During the 2016 open enrollment period, a total of 587,845 new and returning enrollees signed up for health plans through Georgia’s exchange. The state’s enrollment was fourth highest of the 38 states using HealthCare.gov.

As of March 31, 2016, Georgia’s effectuated exchange enrollment stood at 478,000 and 89.4 percent of those enrollees were receiving subsidies that averaged $291 per month.

Georgia and the Affordable Care Act

Georgia politics are dominated by Republicans at the federal and state levels, and the Affordable Care Act is deeply unpopular.

In the 2010 vote on the Affordable Care Act, U.S. Sen. Saxby Chambliss voted no. Sen. John Isakson is listed as not voting on this particular piece of legislation; he has been firmly opposed to the ACA and sponsored legislation for the law’s repeal. In the House, seven Georgia Republican and two Democratic representatives voted no, while four Democratic representatives voted yes.

At the state level, Gov. Nathan Deal and Insurance Commissioner Ralph Hudgens stand out as two of the law’s harshest critics. Georgia defaulted to the federally facilitated health insurance marketplace and did not expand Medicaid. Georgia was among the states that imposed restrictions on navigators, who were intended to help consumers enroll in the marketplace.

During its 2014 session, the Georgia Assembly passed laws that prohibit the establishment of a state-run marketplace, disallow the use of taxpayer money for navigator programs, and forbid government employees from advocating for Medicaid expansion.

Georgia Medicaid

Georgia’s decision against Medicaid expansion leaves 305,000 individuals in the coverage gap, meaning they don’t qualify for either Medicaid or the ACA’s premium subsidies to help offset the cost of private insurance.

Despite the state’s lack of Medicaid expansion, Georgia Medicaid enrollment has increased 15 percent from 2013 to 2016 – the 31st biggest change in enrollment among the 50 states and the District of Columbia.

Georgia’s Medicaid program is not open to non-disabled adults without dependent children, and is only available for parents of dependent children if their household income is under 35 percent of the federal poverty level.

Visit the Georgia Department of Community Health website for information about Georgia’s Medicaid programs.

Other ACA reform provisions

The ACA’s Consumer Operated and Oriented Plan (CO-OP) Program encourages the creation of nonprofit, consumer-run health insurance issuers Twenty-three CO-OPs received funding in the form of loans totaling $1.98 billion, and 12 have folded. No CO-OP plans were created in Georgia.

Medicare in the state of Georgia

Georgia Medicare enrollment reached 1.5 million in 2015, about 15 percent of the state’s population compared with 17 percent of the total U.S. population enrolled in Medicare. Historically, in Georgia, 81 percent of Medicare recipients qualify based on age alone while 29 percent qualify for Medicare as the result of a disability.

Medicare spends about $9,052 annually per recipient in Georgia. As of 2009, the state ranked 11th in terms of overall spending on Medicare with $11.7 billion per year.

Georgia Medicare beneficiaries may choose a Medicare Advantage plan instead of original Medicare as a way to gain additional benefits. 31 percent of Georgians enrolled in Medicare have selected a Medicare Advantage plan instead of a traditional Medicare plan. About 41 percent of Georgia Medicare recipients are enrolled in Medicare Part D to gain stand-alone prescription drug coverage.

Nationwide, 31 percent of Medicare recipients are enrolled in Medicare Advantage plans and 45 percent have Medicare Part D coverage.

State-level reform in Georgia

Here’s what’s happening at the state level with healthcare reform in Georgia:

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