Open enrollment deadline nears for Georgians who qualify for ACA insurance

The state has one of the highest underinsured rates in the country

The federal Centers for Medicare & Medicaid Services (CMS) announced this week that nearly 5.5 million Americans have purchased 2023 health insurance plans on the Affordable Care Act’s marketplace exchanges since open enrollment began on Nov. 1. This includes 335,876 Georgians whose coverage begins Jan. 1 with insurance bought on the HealthCare.gov platform.

In Georgia, the open enrollment period runs from Nov. 1, 2022, to Jan 15, 2023, though people generally need to apply and choose a plan by Dec. 15 if they want their coverage to kick in on Jan. 1, 2023.

This year, the CMS is prioritizing Georgia in its ACA Open Enrollment outreach. The Inflation Reduction Act recently expanded financial assistance to individuals who buy their insurance coverage through the ACA’s federal insurance marketplace, HealthCare.gov. These new subsidies will decrease health insurance premiums for most shoppers – to as little as $10 or less per month for four out of five consumers, according to the CMS.

Q&A on Open Enrollment outreach in Georgia

Credit: Centers for Medicare & Medicaid Services

Credit: Centers for Medicare & Medicaid Services

Q: This year, Atlanta is one of your primary focus areas for outreach because the city has higher levels of uninsured residents. Why is that?

Chiquita Brooks-LaSure, Centers for Medicare & Medicaid Services Administrator: One of the reasons why Georgia has one of the highest uninsured rates in the country is because of the coverage gap – Georgia has not expanded Medicaid. Georgia will be implementing their expansion next year, but that’s been a big reason why Georgia has had a lower rate of insurance compared to [other states].

[In 2021], we had a much more robust outreach and marketing campaign, legislation was passed that made coverage more affordable and we really saw an enormous jump in the people of Georgia who are covered.

Q: What are some of the strategies that have been implemented in getting more people in Atlanta and Georgia covered?

A: There’s been a lot of effort to beef up the navigator program, which we’re putting more dollars into than ever before. We’re also making sure that our messaging, media, and outreach are based on the things that people care about, and one of the things that we are really hearing that people care about is cost.

Q: Why do open enrollment deadlines vary from state to state?

A: The reason why there is some variation in open enrollment is that the federal government, where we run the marketplaces through HealthCare.gov, has one open enrollment period. Different states, like California and New York, have decided to run their own marketplaces, so we allow them to set their open enrollment when it makes sense for them.

I think it’s important to have open enrollment because people … sometimes need deadlines to make sure that they enroll in coverage. We encourage people to [sign up] during our open enrollment period, but there are also special enrollment periods throughout the year, if people have a change in circumstance – like if they get married, have a baby, their income changes or they had coverage and no longer have it.

Q: Do you have estimates for what you expect the overall number of enrollees to be this year?

A: We haven’t put out projections other than to say we were at record numbers last year. At the end of last year’s Open Enrollment, we enrolled 14.5 million people and we really want to make sure that we hold on to that number and build on it. We have made [coverage] available to more people. Before we changed our rules, [people] couldn’t find [Marketplace] coverage if their spouse had employer-sponsored insurance, so there are more people who are eligible right now.

Q: In addition to overall increases in enrollment, do you expect to see any increases in historically marginalized populations like Black, Hispanic, Native American or LGBTQ+ communities?

A: I do expect those numbers to increase. We put a more concerted effort last year into making sure that underserved populations heard about coverage and we saw a huge jump.

This is really the approach that we as an agency are trying to do – unless we are deliberate about trying to make sure that we reach different populations, it won’t happen because it takes time to reach people who are harder to reach ... I think that’s something that the administration learned from the COVID-19 pandemic.

Q: This year, the ACA Marketplace is advertising that it is easier than ever before for consumers to sign up for coverage through HealthCare.gov. Why is that?

A: We’ve made improvements [to the HealthCare.gov website] in terms of plan selection. We continue to try to make the language easier for people that understand their options.

Q: Private insurance premiums are supposed to be going up in 2023. Is this also the case for marketplace plans, and if so, are enrollees who received subsidies shielded from those increases?

A: Premiums overall in the marketplaces have increased. That’s driven by a lot of factors, but part of it is [that] people weren’t getting as much care during the first year of the pandemic. We’re starting to see people going back to the doctor which is a great thing … we want people to use their coverage.

[Marketplace] consumers will not notice premium increases … That’s why it’s been so important that these subsidies were extended and really expanded for middle-class families.

Q: If someone’s already enrolled in a Marketplace plan, would they need to switch plans to take full advantage of these subsidies?

A: You don’t have to switch plans.

Sometimes people go ahead and stay on the same plan. [Looking at other plans] is a good idea, though, and we encourage everyone to take a look because it’s possible that there is a lower-cost plan available now that has the same benefits that you’d like covered. It just changes from year to year and so that’s why we encourage people to go back to HealthCare.gov to just take a look at their options and make sure they’re still in the best plan that works for them.