In 2013, just before Christmas Eve, Ted Officer (right) and his sons Christian and Graham worked late to process Affordable Care Act applications online for clients at USA-Health Insurance in Alpharetta. This year Georgia has experienced one of the biggest surges in Obamacare health coverage sign-ups in the nation. (CURTIS COMPTON / CCOMPTON@AJC.COM)
Photo: Curtis Compton
Photo: Curtis Compton

Obamacare enrollment soars in Georgia

Georgia experienced one of the biggest spikes in Obamacare health coverage sign-ups nationwide this year — up 71 percent from the federal insurance marketplace’s first year of operation, federal data shows.

Roughly 541,000 Georgians enrolled in Affordable Care Act health plans for 2015. More than half are new to the online marketplace and nine in 10 qualify for federal tax credits to help lower their monthly payments.

Experts say the jump in enrollment reflects pent-up demand for health insurance from millions of Americans, especially in states that have not expanded Medicaid as called for by the health care law. Florida, Texas and North Carolina, like Georgia, have not expanded the government health program for the poor and also saw some of the most dramatic Obamacare enrollment increases this year.

“Those are the states with the largest uninsured populations,” said Bill Custer, a health care policy expert at Georgia State University. Those states are also “the ones who have done the least to make an affordable market for consumers.”

At least one Georgian said he is thrilled with Obamacare. Bruce Davenport, 48, of Riverdale said the process was simple and he found a policy to meet his needs for only $38 a month. As the owner of a small gym, Davenport said he understands the importance of good health and good health care.

“It’s been excellent,” he said of the enrollment process.

Despite the large number of sign-ups, however, Georgia continues to have one of the highest uninsured rates in the country, second only to Texas, according to a Gallup survey released earlier this year.

Consumer advocates, community leaders, health care providers and others have urged Gov. Nathan Deal to expand Medicaid, the government health program for the poor. An estimated 300,000 low-income Georgians fall into a so-called “coverage gap” because they make too much to qualify under current Medicaid standards but not enough to qualify for federal tax credits to buy insurance on the marketplace.

“There was a clear, unmet demand (for health insurance) in Georgia, and it’s clear that we’d benefit from expanding Medicaid,” said Cindy Zeldin, head of the nonprofit advocacy group Georgians for a Healthy Future.

Deal and other conservative leaders, however, have remained steadfastly opposed to expansion, saying Georgia can’t afford it. The health program currently provides coverage to roughly 1.8 million poor children, pregnant women, senior citizens and people with disabilities. Expansion would extend coverage to an estimated 600,000 low-income Georgians, mostly adults under the age of 65 who don’t have children.

Georgia is one of 17 states that continue to refuse expansion, according to the nonprofit Kaiser Family Foundation. However, a growing number of red states are pursuing expansion by getting special permission from federal health officials to experiment with more conservative-friendly ways to grow the government program. The feds have granted six states that permission so far in the form of what’s called a Section 1115 waiver.

Advocates say they hope Georgia may soon follow suit.

Last week, health officials here announced that the state plans to ask the Obama administration for a Section 1115 waiver to experiment with Medicaid in an effort to help the state’s safety net hospitals, which lose hundreds of millions of dollars caring for the uninsured each year. The state is also searching for ways to aid Georgia’s rural hospitals, some of which are struggling just to keep the doors open.

“The governor was approached by a group of health care providers interested in exploring an 1115 waiver request,” said Brian Robinson, a spokesman for Gov. Deal. “This waiver, if submitted and approved, would allow the state to cover more Georgians without undertaking Medicaid expansion.”

Deal’s office insists that there are still no plans to expand the program. Zeldin of Georgians for a Healthy Future and other consumer advocates, however, remain hopeful that a Section 1115 waiver could ultimately lead to expansion.

“I’m not at all resigned to having the status quo,” Zeldin said.

Some state lawmakers from rural areas have urged the governor to at least explore how other red states, such as Arkansas, have moved forward with Medicaid expansion. Still, expansion faces an uphill battle with many state lawmakers still firmly opposed to the idea.

State Rep. Jason Spencer, R-Woodbine, a strong opponent of expansion, said he would fight any efforts to grow Medicaid.

“I will admit that (there) are Republicans who are softening, but it will be a bloody battle in the Caucus,” Spencer said. “I will fight Obamacare as long as I am in office.”

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This story was done in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.