Georgia

Georgia health insurance marketplace: history and
news of the state’s exchange

BCBS of Georgia and Bright Health offering plans for 2018; cost of CSR added to silver premiums,making other
metal levels particularly affordable

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Louise Norris
Individual health insurance and health reform authority; broker
March 22, 2018

More Georgia coverage

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    Insurance Guide
    • A guide to health insurance in
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    Medicaid
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    Medicare
    • Insurance for those over 64
      (off-site)

Highlights and updates

  • 2018 enrollment down 4.6% from 2017
  • One insurer in 2017, but Bright Health joined in 2018
  • Average rate increase 15.6%, including added premiums to cover CSR cost
  • Cost of CSR added to silver exchange, other metal levels particularly cheap for some
  • 2018 rates and new insurer indicate death spiral no longer a danger

Georgia exchange overview

Open enrollment ended on December 15, 2017 for the following year, but like Florida, their open enrollment was extended due to it being one of the states that were affected by the recent hurricane. For 2018, there were 480,912 who enrolled in private health insurance plans.

Georgia’s health insurance exchange offers individual plans from four carriers in 2018. Humana was the only insurer to leave the market from 2017. In 2018, the Affordable Care Act is still enacted and its provisions are still required. People who are uninsured for the year 2018 will have penalties on their taxes (unless they are exempt from the penalty). Additionally, Georgia opted to not expand Medicaid under the Affordable Care Act leaving the 240,000 below poverty level who are stuck in the coverage gap (unable to receive Medicaid and ineligible for premium subsidies).

Due to the Affordable Care Act, Georgia has seen a drop in number of uninsured. In 2016, the number of uninsured dropped 31% from 18.8% to 12.9%.

 

Health Ratings

Georgia ranked 41st on the 2017 Scorecard on State Health System Performance in overall healthcare. They were evaluated in five different categories:

  • Access and Affordability
  • Prevention and Treatment
  • Healthy Lives
  • Equity
  • Avoidable Hospital Use and Cost

Georgia ranked the highest in ‘Avoidable Hospital Use and Cost’ category. Georgia also ranked 41st in the 2017 America’s Health Rankings. They ranked extremely low in physical activity, percentage of children living in poverty, and overall uninsured rate but had decently high marks in number of drug related deaths and alcohol use.

2018 Carriers and Rates

In 2018, Georgia has plans from four insurers: Blue Cross Blue Shield of Georgia, Kaiser Permanente, Ambetter from Peach State Health Plan, and Alliant. In 2017, the Trump Administration eliminated funding for cost-sharing reduction and though insurers are required to provide cost-sharing reduction to recipients, they have added the cost of these reductions to silver plan premiums. This rings true for the state of Georgia, and all carriers, besides Kaiser, have added the costs of the reductions to their 2018 plans. A result of this is much larger premiums for recipients—more than a 50% increase.

 

Medicaid

In the past four years, Georgia’s Medicaid has increased 15%. However, Georgia opted not to expand their Medicaid and the states that have expanded saw an increase of 29%. Georgia’s Medicaid program is available for parents of dependent children if their household incomes aren’t above 34% of the federal poverty level—34% of the poverty level for a family of three is only about $579 per month. Additionally, Georgia’s Medicaid program is not open to non-disabled adults without dependent children.

 

Medicare

As of 2015, Georgia’s Medicare enrollment reached 1.5 million which is 15% of the state’s population. In Georgia, 81% of Medicare recipients qualify on age alone while the other 19% qualify as a result of a disability. Each recipient in Georgia costs Medicare about $9,052 annually. Of the overall Medicare recipients, 34% of them enrolled in a Medicare Advantage plan (the national average is 33%). In 2017, 39% of recipients were enrolled in Medicare Part D plan to receive prescription drug coverage (the national average is 44%).

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 healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.