Happening today: ACA open enrollment begins for 2023 health insurance

The 10th anniversary of the once-controversial idea is now a bedrock of Georgia health insurance

Open enrollment got underway Tuesday for health insurance plans on the Affordable Care Act’s marketplace exchange. For the next six weeks, people can shop for plans to begin coverage on Jan. 1, 2023.

This marks the 10th year that individual Georgians have been able to go to healthcare.gov or a navigator or agent to shop private insurance that guarantee coverage of their pre-existing conditions, as well as essential benefits like pharmacy coverage. In that decade the ACA, also known as Obamacare, has become part of the foundation of Georgia health coverage. Just over 701,000 Georgians signed up for a 2022 ACA plan last year.

Gov. Brian Kemp is currently waging a battle to block those Georgians’ access to the federal ACA shopping website, where they can find a comparison of all companies’ plans available to them, and instead refer them directly to insurance companies to find coverage. Kemp argues that private insurance companies will be more helpful to consumers. Kemp’s idea was approved by the Trump administration, but has been blocked by the Biden administration.

ExploreEARLIER IN THE AJC: Under Kemp, state spent $31M on proposal to block Georgians from shopping on healthcare.gov

The ACA market remains stable overall in Georgia. There were big problems in the initial years: Insurance companies misjudged the Georgia market at first and charged too little. Some lost money and fled. Others decided to stay, but their rates soared. In recent years, Georgia’s ACA marketplace exchange has stabilized and attracted additional insurance companies.

Premium prices have become more affordable because of new subsidies enacted in Georgia both by President Joe Biden’s American Rescue Plan and at the state level by Kemp’s “reinsurance” waiver. Both of those initiatives subsidize premiums, lowering costs especially for those in the middle-and upper-income brackets.

For policyholders who earn less, especially just over the poverty level, ACA subsidies have always made premium prices lower or even free.

Although prices overall may average out as stable, there is often a big change in an individual plan here and there. For example, Ambetter, a major company for Middle Georgia, is nearly doubling the price of its “gold” plan for those who make more than $100,000 per year — up from $376 per month to $714 per month, said Americus agent Kirk Lyman-Barner. Still, those plans may have buyers because the deductible remains only $750 per year.

Lyman-Barner spoke from his office Tuesday, where he has added two additional workers to help handle ACA open enrollment. He and his team were busy calling customers Tuesday and walking them through their options.

The customers in that older bracket with the higher incomes were backing away at Ambetter’s increased prices, he said. But most ACA policyholders qualify for more affordable plans, and they were readily re-enrolling, he said.

“We’re super busy,” he said.

The marketplace is open for shopping until Dec. 15 for plans starting Jan. 1. Enrollment is open until Jan. 15 for coverage beginning Feb. 1. After that, enrollment closes to most people. To find your price, here are some shopping resources.

RESOURCES

Healthcare.gov

1-800-318-2596

TTY: 1-855-889-4325

This is the main federal shopping website for ACA plans. It allows you to input your expected income level, family size and ZIP code, and then gives you plans and prices you’re eligible for. It presents them together in order to contrast and compare. It allows shoppers to check if their doctor or hospital is currently in the plan’s coverage network. The website has translations in 15 languages in addition to English.

Healthsherpa.com

1-855-772-2663

This is a privately run website that does most of the things Healthcare.gov does. Some agents and shoppers say it’s easier to use.

InsureGA.org

1-866-988-8246

Insure Georgia was a navigator organization, but suffered big funding cuts under the Trump administration. It is now registered as a nonprofit insurance agency, and continues helping people sign up for ACA plans. It’s based in Macon and helps people across the state.

NAVIGATORS

Navigators can help people sign up for ACA plans and also explain who’s eligible for Medicaid or Medicare. The funding numbers reflect the federal dollars spent to ensure each navigator is staffed and ready to answer consumer’s calls.

The Georgia Association for Primary Health Care (GAPHC)

1-844-442-7421

Federal navigator funding: $2.5 million

Assistance can also be requested on its website, www.georgiapca.org, under “Resources, Outreach & Enrollment.”

A network of clinics, this group is also subcontracting out to the Hispanic Health Coalition of Georgia (HHCGA), the North Georgia Healthcare Center, the Center for Pan Asian Community Services, the Spring Creek Health Cooperative, and Georgians for a Healthy Future. Its grant award states, “GAPHC will provide assistance to any consumer seeking assistance.”

Georgia Legal Services Program (Georgia ENROLL)

1-866-442-3676

Federal navigator funding: $488,248

Works in the 47 rural Georgia counties with the highest uninsured rates; does not work in Atlanta. The organization has experience helping people navigate legal difficulties with Medicaid, and is targeting vulnerable populations for assistance.

Mercy Care

678-843-8527

Federal navigator funding: $170,042

Working in DeKalb and Fulton counties. Assisting people experiencing homelessness, marginally housed, and low-income individuals.