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Georgia’s Health Insurance Exchange Marketplace

Georgia employs the federally run health insurance exchange, so enrollments are completed through HealthCare.gov.

Open enrollment for 2021 health plans will run starting November 1, 2020, to December 15, 2020. Outside of that window, persons with qualifying events can still enroll or make changes to their health insurance plans for 2020.

Effectuated enrollment in Georgia’s health insurance exchange stood at more than 396,000 persons as of mid-2019. During the open enrollment period for 2020 coverages, 463,910 persons signed up for private plans through the state’s exchange.

HHS estimated that 581,000 individuals in Georgia gained health insurance coverage from 2010 to 2015, as a result of the ACA. But Georgia has not expanded Medicaid under the Affordable Care Act, so the state has not taken full advantage of the ACA’s provisions. There are currently an estimated 255,000 individuals in the coverage gap in Georgia — ineligible for premium subsidies because they earn too little, and ineligible for Medicaid since the state has not accepted federal funding to expand coverage. A recent analysis by the Robert Wood Johnson Foundation estimated that Georgia’s uninsured rate would drop by nearly a third if Georgia were to expand Medicaid.

After many years of insurer exits and fairly substantial rate increases, Georgia’s individual insurance market appears to be stabilizing. The average rate increase for 2019 was lower than 4 percent, and average rates decreased slightly for 2020. And two new insurers — Oscar and CareSource — started offering coverage in Georgia’s exchange for 2020.

Georgia’s Health Insurance Marketplace Background

Georgia chose to use the federal health insurance marketplace, HealthCare.gov. State government officials like former Gov. Nathan Deal and former Insurance Commissioner Ralph Hudgens vocally opposed the ACA.

Hudgens implemented a requirement that navigators, who help customers use the marketplace, pass the test that insurance agents are required to take. That requirement was much more stringent than required by the health care reform regulation, and Hudgens openly stated it was intended as obstructionism. At the end of its 2014 session, the Georgia Assembly passed a bill that prohibits establishing a state-run marketplace, does not allow the use of taxpayer money for navigator programs, and forbids government workforces from advocating for the expansion of Medicaid.

Georgia’s director of Enroll America, Dante McKay, said that lack of access to navigators affected enrollment in rural Georgia counties in 2014. McKay also said the amount of federal funding Georgia received for navigators was among the lowest of all the states as per uninsured individual basis in 2013 — and the amount reduced in 2014.

Georgia has also therefore refused to accept federal funding to expand its Medicaid program under the ACA. Gov, leaving up to 255,000 low-income people in a coverage gap — unable to be eligible for either Medicaid or subsidies through the marketplace.

Enrolling in Georgia’s Health Insurance Exchange Marketplace

As is the case in many states that use HealthCare.gov, enrollment peaked in Georgia’s exchange in 2016. Although it declined in 2017, 2018, and 2019, it grew to some extent in 2020 — although it is still far below what it was in 2016.

The decrease in enrollment has been as a result of several variables, as well as higher premiums for individuals who do not get premium subsidies.

GOP sabotage of the Affordable Care Act (which is part of the reason for the rate increases) also has a lot to do with it: There is no longer a penalty for being uninsured after the end of 2018, and the Trump administration again reduced subsidy for outreach and enrollment assistance in the weeks leading up to open enrollment, after doing the same thing in 2017. Additionally, the Administration has expanded access to short-term health insurance plans and association health plans, letting them serve as alternatives to ACA-compliant coverage for healthy applicants.

Resources and References:

• Number of People Who Signed Up for Private Plans in the State’s Exchange
• Implication of Medicaid Expansion