Georgia has seen a drop-off in enrollment this year under the Affordable Care Act, particularly in the Augusta area, according to one advocacy group.
The confusion and big cuts to in-person assistance probably won’t help turn that around as Open Enrollment for 2018 begins next week, the group said. Experts said it is important for people not to assume coverage won’t be affordable because subsidies rise with premium increases and it is best to start checking and trying to enroll as early as possible because of the shortened period for Georgia and South Carolina.
Georgia saw a drop in total enrollment from 587,845 in 2016 to 493,880 in 2017, a decline of nearly 94,000 or 16 percent, according to Georgians for a Healthy Future. It was particularly true for Richmond and Burke counties, who saw some of the biggest declines in the state, according to the group.
Richmond County went from 10,259 to 6,994, a drop of 32 percent, while Burke lost enrollment from 1,302 to 872, a drop of 33 percent. This came despite what statewide assistance group Insure Georgia called “great turnouts” at two large events to help people enroll in the area, said Executive Director Sarah Sessoms. The group did have a hard time getting people enrolled in Richmond County in Blue Cross Blue Shield of Georgia, the sole marketplace provider for the county and much of Georgia, because of a provision in the coverage that required patients to get a primary care provider’s referral to see a specialist, she said.
“I guess consumers didn’t like that at that time,” Sessoms said.
Nationwide, grants to groups to provide in-person assistance were cut 41 percent but those cuts were more severe for Georgia which was cut 61 percent, and South Carolina, which took a 66 percent hit. Still, Insure Georgia said it plans to have enrollment events in almost all counties and will have a Web site and assistance available by phone as well and plans to average 11 events a day across the state, Sessoms said. Palmetto Project will also be providing assistance in South Carolina despite the funding loss, said Shelli Quenga, director of programs.
“We are still available,” she said.
Still, in this upcoming enrollment, the fifth for the Affordable Care Act, consumers are likely to face “uncertainty, confusion and misinformation,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation. For instance, President Trump has vowed to stop making cost-sharing reduction payments to insurance companies to compensate them for providing additional assistance to low-income people on Silver-level plans to help them pay for things like deductibles and co-pays.
But those payments will still be available to consumers next year as part of their coverage and will still make a big difference in the affordability of that coverage. For instance, if the average deductible on a Silver plan is $3,609, cost-sharing payments can drop that to $809 for a person at 200 percent of the federal poverty level or $23,760 a year and $255 for someone at 150 percent of the poverty level, or making $17,820 a year.
Insurance companies would then bill the federal government for the difference but, with many anticipating the payments might go away, those companies turned in much higher premiums for 2018 to try and make up the difference, Pollitz said. BCBS of Georgia, for instance, hiked rates by an average of 57.5 percent for next year, according to Georgians for a Healthy Future.
While that may seem alarming, subsidies rise as premiums do and “the subsidy will end up covering this cost increase,” for most patients, Pollitz said. Because that subsidy comes from the federal government, even if the cost-sharing payments go away, “at the end of the day this is all going to be paid by the federal government,” she said.
Still, enrollment assisters worry people will be too concerned about those premium hikes to seek coverage.
“Consumers should not be scared off by reports of double-digit increases,” Sessoms said.
The best thing to do is to begin as soon as possible and just see what the options and prices are, Pollitz said.
“Don’t wait,” she said. “Start as early as you can.”
Still, with all of the confusion entering into this enrollment period, those challenges “are likely to lead” to worse enrollment for next year, Georgians for a Health Future said in its report, “Getting Georgia Covered.”
And while Pollitz was reluctant to make a prediction before enrollment begins, “there is an expectation that enrollment could drop off.” she said.
Reach Tom Corwin at (706) 823-3213 or email@example.com.