Georgia health insurance

Georgia is seeking federal approval for a reinsurance program in addition to extensive other changes to its insurance market; short-term plans are now available with plan terms up to 364 days.

Main Street, Plains, GA | © Chuck Smith-Dewey

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 2020 health plans has ended, although Georgia residents with qualifying events can still enroll or make changes to their coverage for 2020. The next open enrollment period, for plans effective in 2021, will begin November 1, 2020.

Six insurers are offering 2020 coverage through the exchange, including newcomers Oscar Health and CareSource.

Read our overview of 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.

Georgia is seeking federal approval for a partial expansion of Medicaid, which would cover people with income up to the poverty level (as opposed to 138 percent of the poverty level, as called for in the ACA). But CMS rejected a similar proposal from Utah, so it’s unclear whether Georgia officials will be successful in their bid to receive federal Medicaid expansion funding without fully expanding Medicaid.

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 a 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 by 2018, the state’s uninsured rate had crept back up to 13.7 percent. Nationwide, the uninsured rate stood at 8.9 percent in 2018, and had been 14.5 percent in 2013. Georgia’s refusal to accept federal funding to expand Medicaid is a big 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. Neither is still in the Senate, but their replacements, David Perdue and Kelly Loeffler, are both Republicans. Perdue was in the Senate in 2017 and voted in favor of repealing the ACA in 2017, although those repeal bills were never enacted. Loeffler joined the Senate in 2020, but hasn’t taken a position on whether the ACA should be overturned.

In the House, seven Georgia Republican and two Democratic representatives voted against the ACA in 2010, while four Democratic representatives voted yes. As of 2020, Georgia’s House delegation includes four Democrats and eight 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. Brian Kemp is opposed to the ACA but has proposed sweeping modifications to Georgia’s insurance market using 1332 waivers, as well as a partial expansion of Medicaid. A Brookings Institute analysis noted that what Georgia is proposing with its insurance market isn’t lawful, and the federal approval process is likely to be lengthy. But Georgia is also seeking swift federal approval for a reinsurance program that could help to lower premiums in the state’s individual market as of 2021.

Medicare in the state of Georgia

As of late 2019, there were more than 1.7 million Georgia residents enrolled in Medicare.

You can read more about Medicare in Georgia, including details about Medicare Advantage and Medicare Part D, as well as the state’s rules for Medigap plans.

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.

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