“Keep calm and carry on” was the slogan on a widely distributed poster in Great Britain just before World War II; it has been gaining popularity again just in time for the implementation of the Affordable Care Act. While the issues we face are far less harrowing than those Britons faced, it would be difficult to tell that from the rhetoric surrounding the ACA.
In truth, most Georgians will experience either no change or only a small change (1 percent or less) in premiums and benefits in 2014 as a result of the ACA. That is because more than two-thirds of Georgians have large-group employment-based coverage, or have Medicare or Medicaid coverage. Large employers do face additional costs in new taxes, and some will have to change their benefit plans, but the average costs of these changes will be between half-percent and 2 percent of premiums.
The Georgians most directly affected by the Affordable Care Act are those who purchase individual health insurance coverage, small employers and those currently uninsured. ACA’s goal is to allow those individuals access to the same health insurance coverage at the same prices as employees of large firms (and Congress, for that matter). It generally achieves that goal by fundamentally restructuring the individual insurance market for coverage purchased on the exchange or outside of it. While it has always been good advice, this year especially it is important for consumers to shop carefully for health insurance.
The number of insurers participating in the exchange, the number and types of plans, the features of each plan, and the premium each individual would pay has been known by the state and federal agencies setting up the exchange since early August, but it hasn’t been made available to consumers. Instead, consumers have been subject to a great deal of misinformation on the available options and their premium costs.
Consumers comparing health plans need to examine premiums, out-of-pocket costs under a plan and the range of choices of providers participating in the plan. The website Healthcare.gov was intended to give consumers that information, but its failures have been well documented. Consumers don’t need to use that website to enroll; they can apply by the phone or with a paper application. But the website’s failure means consumers will have difficulty comparing plans. Until Healthcare.gov is fully functional, consumers will need to do a bit of legwork to understand the choice of providers in each plan. That information is available on the each insurer’s website.
Healthcare.gov has created a workaround, so individuals can see the plans available to them in each region of the state. Readers can access this part of the website without delays and compare plans available in Georgia. The premiums listed here are not the exact premiums; it gives premiums in age ranges. However, there are calculators consumers can use get a sense of their total costs of coverage (premium minus subsidy, if any) on websites of the AJC (http://www.myajc.com/s/news/healthcare-georgia/), WebMD (http://www.webmd.com/) and Kaiser Family Foundation (http://kff.org/).
William S. Custer is director of the Center for Health Services Research at Georgia State University.
