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Georgia health insurance

Four insurers offer 2019 coverage through Georgia's marketplace; short-term plans are now available with plan terms up to 364 days.

Health insurance in Georgia

Georgia’s health insurance marketplace

State legislative efforts to preserve or strengthen provisions of the Affordable Care Act

Georgia is among the states that have done the least to preserve the Affordable Care Act’s gains.

Georgia uses the federally-run health insurance exchange, so enrollments are completed via Open enrollment for 2019 coverage ended on December 15, but enrollment is still possible for Georgians who have qualifying events.

In addition, residents in a wide area of southwestern and central Georgia who were affected by Hurricane Michael in October 2018 have until February 20, 2019 to enroll in coverage for 2019. Residents in counties deemed eligible for FEMA assistance were initially granted a special enrollment period through December 22, 2018 (60 days after the FEMA-declared Michael incident ended in Georgia). But CMS issued additional guidance in December that gives affected residents in those counties another 60 days (through February 20, 2019) to enroll in a plan for 2019.

Affected individuals must call the exchange at 1-800-318-2596 or TTY at 1-855-889-4325 and attest that they were unable to enroll during open enrollment as a result of Hurricane Michael.

Four insurers that offered coverage in 2018 are continuing to offer 2019 plans through the exchange. Average rate increases for plans in Georgia’s individual market are less than 4 percent for 2019.

Last year, 480,912 Georgians enrolled in private health insurance plans for 2018 through the Georgia exchange. By the end of open enrollment for 2019 plans, 460,139 people had selected plans in Georgia’s exchange.

Read more about Georgia’s health insurance marketplace.

Medicaid coverage in Georgia

The benefits of Medicaid remain out of reach for many Georgians. Georgia has not accepted federal funding to expand Medicaid under the ACA, and the state’s Medicaid program is more restrictive than average, with only six states having lower income limits for Medicaid eligibility for low-income parents.

An estimated 726,000 Georgians would gain coverage if the state accepted the Medicaid expansion.

Read more about Medicaid expansion in Georgia.

Short-term health insurance in Georgia

Georgia does not have state-specific regulations for short-term health insurance plans, so the state defaults to the federal regulations.

That means insurers in Georgia can offer short-term plans with initial terms up to 364 days and the option to renew for a total duration of up to 36 months. (Insurers can also offer plans with shorter maximum durations, however, and prohibit renewal if they choose to do so.)

Read more about short-term health insurance in Georgia.

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 neither 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 2016, the percentage of Georgia residents without health insurance dropped 5.9 percentage points from 18.8 to 12.9 percent (about a 31 percent decrease), according to U.S. Census data. But in 2017, the state’s uninsured rate crept back up to 13.4 percent. Nationwide, the uninsured rate went from 14.5 to 8.6 percent (nearly a 41 percent decrease) from 2013 to 2016, and increased slightly, to 8.7 percent in 2017. Georgia’s refusal to accept federal funding to expand Medicaid is a bit part of why the state’s uninsured rate is higher than the national average.

Georgia and the Affordable Care Act

Georgia politics are dominated by Republicans at the federal and state levels, and the Affordable Care Act has generally been deeply unpopular with local lawmakers.

When the Senate voted on the Affordable Care Act on Christmas Eve, 2009, Republican U.S. Senators Saxby Chambliss and John Isakson both voted against the bill. Isakson is still in the Senate, and the current Junior Senator, David Perdue, also a Republican, is opposed to the ACA. Both men voted in favor of repealing the ACA in 2017, although the only measure that Republicans were ultimately able to pass was repeal of the individual mandate starting in 2019.

In the House, seven Georgia Republican and two Democratic representatives voted against the ACA in 2010, while four Democratic representatives voted yes. As of 2018, Georgia’s House delegation includes four Democrats and ten Republicans. During the 2017 legislative session, Representatives from Georgia were split along party lines in terms of their votes for or against ACA repeal.

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.

Medicare in the state of Georgia

Georgia Medicare enrollment reached  nearly 1.7 million by late 2018. That was about 16 percent of the state’s population compared with 18 percent of the total U.S. population enrolled in Medicare. In Georgia, 82 percent of Medicare recipients qualify based on age alone while 18 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. 34 percent of Georgians enrolled in Medicare have selected a Medicare Advantage plan instead of a traditional Medicare plan, which is very much in line with the national average of 33 percent.

In 2017, about 39 percent of Georgia Medicare recipients were enrolled in Medicare Part D to gain stand-alone prescription drug coverage, versus 44 percent nationwide.

Georgia health insurance resources

State-level reform in Georgia

Scroll to the bottom of this page for a summary of what’s happening at the state level with healthcare reform in Georgia.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.