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Georgia health insurance

GA sees drop in uninsured, but over 300,000 remain in coverage gap

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 25 percent on 14 of 46 measures, including uninsured adults and children; children with emotional, behavioral or developmental problems who received needed mental healthcare in the past year; obesity in children; and percent of adults who have lost six or more teeth because of tooth decay, infection or gum disease. See Georgia’s scorecard for more details about its ranking on individual health indicators.

In the 2014 America’s Health Rankings, Georgia placed 38th and placed in the bottom 25 percent on 11 of 33 core measures, including lack of health insurance, low birthweight, dentists and infectious disease. The state ranked well when it came to having a low number of occupational fatalities.

While the data is not summarized into an overall score, the 2015 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.

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.

How has Obamacare helped Georgia?

From 2013 to 2014, the uninsured rate in Georgia dropped from 21.4 percent to 19.1 percent. By mid-2014, the uninsured rate fell to 15.3 percent, a total change of 6.2 percentage points, slightly higher than the 5.3 percentage-point change experienced in other states that implemented either a state-run marketplace or Medicaid expansion or implemented neither of those measures

The failure to expand Medicaid expansion or implement a state-run exchange (in many states, an indication of ACA opposition) and limitations on navigators are all factors in the moderate decline.

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 2015 open enrollment period, 541,080 people enrolled in a QHP through Georgia’s exchange. As happens nationwide, some of those individuals dropped their coverage or failed to make their initial premium payments. By June 30, 2015, there were 417,890 people still enrolled; 90 percent of them were in plans with advanced premium tax credits and 67 percent were receiving cost-sharing subsidies.

Nine carriers are offering 2016 plans through Georgia’s health insurance exchange:

  • Aetna Health
  • Alliant
  • Blue Cross Blue Shield of Georgia
  • Cigna
  • Harken Health Insurance – new to the exchange for 2016
  • Humana
  • Kaiser Permanente
  • Peach State Health Plan
  • UnitedHealthcare HMO

Time Insurance previously offered individual coverage through Georgia’s exchange; however, the company left the market nationwide.

In Georgia, the average benchmark premium increased 6.1 percent for 2016; lower than the average of 7.5 percent among all 37 states that used in 2015.

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 14 percent from 2013 to 2015 – the 30th 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 14.8 percent of the state’s population compared with 17 percent of the total U.S. population enrolled in Medicare. Historically, in Georgia, 78 percent of Medicare recipients qualify based on age alone while 22 percent are on Medicare as the result of a disability.

Medicare spends about $9,835 annually per recipient in Georgia, and the state ranks 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 some additional benefits. Thirty-two 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, 32 percent of Medicare recipients are enrolled in Medicare Advantage plans and 43 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: