Even with the Affordable Care Act, 1.5 million in Georgia will be without health insurance because the state refuses to expand Medicaid, a nonpartisan group said Monday.
With the deadline for open enrollment in the Health Insurance Marketplaces ending March 31, a study found half of those surveyed did not know about the marketplaces and many lacked knowledge about basic insurance components, such as deductibles.
In a report designed to serve as a “baseline” for what progress might be attained through the Affordable Care Act, the Commonwealth Fund released a report that found in addition to 47 million that were uninsured in 2012 there were another 32 million who were underinsured. That was defined as having insurance coverage so poor that the family spent at least 10 percent or more of its income on medical costs.
In Georgia, the 1.8 million uninsured were joined by slightly more than a million underinsured in 2012, the report found. The majority of both groups in Georgia made less than 200 percent of the poverty level or less than $47,100 for a family of four. The report will establish a “baseline” of health care need as coverage under the Affordable Care Act kicks in this year, said Dr. David Blumenthal, president of the group.
“It will be important to continue to monitor trends in the rates of underinsured, in addition to the rates of uninsured, to establish whether the Affordable Care Act is achieving its goals,” he said. “It will be especially important to monitor what happens in states that decline to expand Medicaid.”
The way the act was originally constructed, a federally-funded expansion of state Medicaid programs was to cover most low-income people and therefore the act was to prohibit subsidies through the marketplace for those at federal poverty level to prevent states from dumping Medicaid patients onto the marketplaces.
The U.S. Supreme Court struck down the part of the act that would allow the federal government to penalize states that did not expand Medicaid, making expansion optional,and 23 states, including Georgia and South Carolina, have since refused. That leaves those under the poverty level, $23,550 a year for a family of four, without access to coverage or underinsured, which the group estimated was 15 million people. In Georgia, that number is close to 1.5 million, said researcher Cathy Schoen.
“There is a lot at stake when we exclude vast numbers of under (age) 65, whether it is children or young adults, from insurance and the opportunity to live a healthy productive life,” she said. “I think over time, this is the optimist, we will see states saying, ‘Wait a minute, this is an economic issue, this is a health issue, this is an attractive-place-for-business-to-come issue, let’s join.’”
More troubling for those trying to enroll people in the Health Insurance Marketplaces, many of those who need them don’t know what they are. A study out of the University of Southern California, published Monday in the Proceedings of the National Academy of Sciences, found that before enrollment 64 percent of the uninsured had not heard about the marketplaces meant to help them . Only 31 percent knew about the subsidies that might help them pay for coverage, the study found.
Many were not familiar with basic insurance concepts, with only 42 percent familiar with the deductible/premium tradeoff, according to the report. Lack of familiarity is why many did not enroll early or waited, Blumenthal said.
“One of the leading reasons for that is they weren’t sure the plans were right for them,” he said.