Georgia Health insurance

Health insurance in Georgia

● Georgia uses a federally subsidized health insurance exchange.

● The open enrollment for 2021 health plans is from 1 November to 15 December 2020. Residents with qualifying events can sign up or make changes to their coverage outside that window.

● Short-term health plans can be sold in Georgia with initial piano terms of up to 364 days.

● Six insurers will offer 2021 coverage through Georgia's health insurance marketplace, with an overall average rate increase of about 4.8%.

● Georgia has not accepted the ACA's Medicaid expansion, but is seeking federal approval for a partial Medicaid expansion.

This page is dedicated to helping consumers quickly find health insurance resources in the state of Georgia. Here you will find information about the many types of health insurance, also known as medical insurance, available. You can find the basics of Georgia's health insurance marketplace and the upcoming open enrollment period; a brief overview of Medicaid expansion in Georgia; a quick look at the availability of short-term health insurance in the state; statistics on state-specific Medicare rules; as well as a collection of Georgia health insurance resources for residents.

Georgia's health insurance marketplaceplace

The Georgia use the exchange/marketplace of the federally managed health insurance, then enrollments are completed through HealthCare.gov. The exchange is for the people who buy their own health insurance, which includes the self-employed, early retirees who are not yet entitled to Medicare, and people who are employed in a small business that does not provide greeting benefits.

Georgia has proposed a single 1332 waiver - which is still being reviewed by HHS - that would eliminate the exchange in Georgia and instead be part of the people on health plans through brokers, agents and insurance companies. An analysis by the Brookings Institute noted that what Georgia is proposing with its insurance marketplace is not legal and the federal approval process is likely to be lengthy.

Georgia is also seeking federal approval to create a reinsurance program, but this has been delayed until 2022.

Six insurers offer 2020 insurance coverage through Georgia's health insurance marketplace, including newcomers Oscar Health and Care Source: All and you will continue to offer plans for 2021, with average rate changes ranging from a 19% decrease to a 10% increase. Across the marketplace, the overall change in the average rate for 2021 is about a 4.8% increase.

The service areas vary from insurer to insurer, the majority of trade enrollees in Georgia have access to the plans of at least three different health insurance companies. Much of the state has only one or two insurers offering plans, but the state's most populous parts are included in multiple insurer service areas.

Georgia open enrollment period and dates

Open enrollment for 2021 health plans runs from November 1, 2020 to December 15, 2020. This registration window applies both on the stock exchange and out of exchange. You an opportunity for individuals and families to renew existing coverage, update the exchange if they have had changes to their income or family size in the last year, or switch to a different health insurance policy for 2021. It is also an opportunity for the new enrollees to enroll in coverage, with financial assistance - for premiums and/or out-of-pocket costs - based on family income (financial assistance is only available through exchange; people who sign up directly through a health insurance company do not receive any benefits).

Outside the open enrollment window, Georgia residents can only enroll in individual medical greeting plans if they experience a qualifying event.

Medicaid expansion in Georgia

Medicaid benefits 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 of the media, 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 incomes up to poverty level (versus 138% of the poverty level, as required by the ACA). But CMS He rejected a similar proposal from Utah in 2019, so it's unclear whether Georgia officials will succeed in their attempt to receive federal funding for Medicaid expansion without fully expanding Medicaid.

Short-term health insurance in Georgia

The Georgia doesn't have state-specific regulations for short-term health insurance plans, so the state doesn't comply with federal regulations.

This means insurers in Georgia can offer short-term plans with initial terms of up to 364 days and the ability 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.)

How did Obamacare help Georgia?

The states of the most successfully reduced their uninsured population through the Affordable Care Act have implemented a state or partnership exchange and/or expanded Medicaid. Georgia hasn't done any of these things, which is typically an indication of opposition to the ACA.

The state's uninsured rate saw a moderate decline from 2013, just before Obamacare's plans were put in place. Until 2016, the percentage of Georgia residents without health insurance fell by 5.9 percentage points from 18.8 percent to 12.9 percent (about a decrease of 31 percent), according to U.S. Census data. But by 2018, the state's uninsured rate had returned to 13.7%. Nationally, the uninsured rate stood at 8.9% in 2018 and was 14.5% in 2013. The refusal of Georgia to accept federal funding to expand Medicaid is an important part of why the state's uninsured rate is higher than the national media.

But as of December 2020, there were more than 433,000 Georgia residents enrolled in private health plans through the exchange. 91% of these enrollees received premium subsidies that made their monthly premiums much less expensive, and 68% were able to reduce cost sharing, which makes out-of-pocket medical expenses (deductible, copays, coinsurance) more affordable. All of these subscribers -- as well as out-of-stock enrollees and people with small-group coverage purchased since 2014 -- have plans that provide coverage for the benefits essential to the ACA salute. None of them have to worry about pre-existing conditions be excluded or to reach a maximum of a lifetime or annual allowance if they get very ill. These improvements are all the result of the ACA.

Georgia and the Affordable Care Act

Georgia's policy is 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 passed the Affordable Care Act on Christmas Eve 2009, Republican U.S. Senators Saxby Chambliss and John Isakson both voted against the bill. Neither is yet 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, though such repeal bills were never enacted. Loeffler entered the Senate in 2020, but took no position on whether to overthrow the ACA.

In the House, seven Republican representatives from Georgia and two Democrats voted against the ACA in 2010, while four Democratic Democrats voted yes. As of December 2020, Georgia's House delegation includes four Democrats and eight Republicans. During the 2017 legislative session, Georgia's representatives were divided along party lines in terms of votes for or against repealing the ACA.

At the state level, Governor Brian Kemp has a very conservative approach to government and is opposed to the ACA. Kemp proposed sweeping changes to the Georgia insurance marketplace using 1332 waivers, as well as a partial expansion of Medicaid.

Medicare coverage and enrollment in Georgia

As of August 2020, there were nearly 1.77 million Georgia residents enrolled in Medicare. Most are eligible for Medicare because of age, but 17% of Georgia Medicare beneficiaries are under 65 and are eligible for Medicare due to a disability.

Georgia Health Insurance Resources

● Department of Health of the Community of Georgia (DCH)

● Commissioner for Insurance and Safety Fires - Rule and license health insurance products sold in the state, as well as brokers and agents who sell them.

● Georgia Cares State Health Insurance Assistance Program - A resource for Medicare beneficiaries and their caregivers, providing advice and assistance with various Medicare problems.

● (GAPHC) - Georgia Community Health Centers, also by a federally funded Navigator organization, are being treated for people to enroll in coverage (private health plans or Medicaid) in the exchange.

● Medicare Rights Center - a national resource that includes a website and call center where people can get help with Medicare applications.