How will a Trump presidency impact health insurance in Georgia? That remains to be seen (though we’ve made some general predictions about his influence on health reform here). For now, however, 2017 open enrollment is underway, and the Affordable Care Act remains in effect. That means the individual mandate still applies, and those who are not exempt must enroll in ACA-compliant coverage.
Georgia’s health insurance exchange will offer individual plans from five carriers for 2017. It is a noticeable reduction from nine carriers in 2016. In addition to fewer carrier options, Georgians may notice rate increases and coverage-area reductions.
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). 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 the uninsurance rate, the ratio of dentists to state residents, and access to clinical care.
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 opposition to the ACA.
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, Harken and Aetna will exit the state’s exchange at the end of 2016. The following carriers will remain, and their average approved rate increases are also listed:
- Blue Cross Blue Shield of Georgia: 21.4 percent; only carrier to offer exchange plans in all 159 of Georgia’s counties
- Humana: 67.5 percent; will reduce coverage to Atlanta, Columbus, Macon and Savannah areas
- Kaiser Permanente: 17.6 percent increase
- Ambetter from Peach State Health Plan: 13.7 percent
- Alliant: 21 percent
Faced with rate increases and carrier exits, consumers will want to shop around. Subsidies will help those who are eligible reduce their monthly premium rates. 2017 open enrollment ends January 31.
Georgia enrollment in qualified health plans
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’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.
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: