The uninsured rate among adults has dropped in Georgia since 2013 due to coverage from the Affordable Care Act, but the state still ranks among the worst, particularly among the low-income and ethnic minorities, according to the nonpartisan Commonwealth Fund. Those gains could also be in danger due to changes in the law, including a shortened enrollment period that ends Friday.
In a report today, the group found between 2013 and 2016, the uninsured rate for adults under age 65 dropped nationally from 20 percent to a historic low of 12 percent, and in Georgia fell from 26 percent to 18 percent. But that is still tied for the third worst rate – with Alaska, Florida and Mississippi – behind only Texas and Oklahoma, and the state is tied with Florida for the third highest percentage of adults who skipped care because of cost, behind only Texas and Louisiana.
The state is tied for the second-worst uninsured rate among those with income at 200 percent of the federal poverty level or below, at 35 percent with Oklahoma and only Texas was worst. People at that income level, which in 2016 was $49,000 a year or less for a family of four, has often been “at greatest risk for being uninsured, ” said Susan Hayes, lead author of the study and a senior research at Commonwealth.
Almost all of the biggest gains in coverage and access were among those that, unlike Georgia, chose to expand Medicaid, she said.
“In many states, people are better able to get and afford the health care they need and fewer households are spending a large portion of their income on medical care,” Hayes said. “Medicaid expansion has been essential to that success.”
Of the 13 states that experienced double-digit declines, only Florida did not expand Medicaid and Florida enrolled the most people through the ACA, she said. In a study looking at the differences between states that expanded Medicaid and the 19 that did not, “we see a substantial increase in the number of low-income individuals who report that their health is good or excellent and a decline in the numbers who report their health is poor or very poor,” said Dr. David Blumenthal, president of Commonwealth. Those measures have been shown to correlate with mortality rates, he said.
But recent action by the Senate and now a conference committee to repeal the individual mandate to carry health insurance or face a penalty, as well as the failure thus far to fully fund the Children’s Health Insurance Program, could impact that, Blumenthal said.
“These actions could lead to a reversal of the gains we’ve made and cause millions of people to lose their health care coverage,” he said.
There is also concern about the impact of a much shorter Open Enrollment period this year that ends for many states on Friday, said Sara Collins, vice president for health care coverage and access at Commonwealth. Through Saturday, 4.7 million had enrolled this year, including nearly 1.4 million new customers, which was ahead of last year’s numbers, but may still come up short of the 10.1 million total from the previous year.
“This is clearly a critical week,” Collins said.
In Georgia, nearly 250,000 had enrolled, about half of the total who did during the last period. At Insure Georgia, which was trying to help people enroll statewide despite heavy cuts to its funding, it looked like they were seeing about 80 to 90 percent of what it did during the last enrollment, but that did not include this week’s numbers, said Fred Ammons, CEO of parent company Community Health Works.
The group has also been trying to address an apparent snafu in the more than 70 counties Blue Cross Blue Shield of Georgia withdrew from for next year. The plans that replaced Blue Cross sent out auto-re-enrollment letters using the 2017 subsidy to estimate monthly premiums, Ammons said.
“But here’s the problem: When Blue Cross/Blue Shield pulled out of an area, the benchmark plan for that area generally went up in price” and, likely, the subsidy for next year would too, but that is not reflected in the estimated premium, Ammons said.
“It may discourage people,” he said.
“There may be some things we can do,” Ammons said. “Your premiums may not be as high as it says in the auto-re-enrollment letter. There is no harm in calling and trying to get help. We have folks here. We have resources. Let’s not let confusion, misinformation or anything be a barrier to getting access to health care that folks need.”
Reach Tom Corwin at (706) 823-3213 or firstname.lastname@example.org