The federal government has numbers but they don’t tell much of a story yet, since most people tend to wait until the end of the enrollment period to sign up. Open enrollment on the ACA exchange runs from Nov. 1 to Dec. 15. The plans begin coverage on Jan. 1.
The government releases sign-up totals in weekly snapshots. This year’s first week contained only two days, a Friday and a Saturday. It said 177,000 signed up nationwide. That’s well under the daily average for week one of the year before, but it includes the long shutdown on the first day.
On the Obamacare exchange individual insurance plans must cover “essential health benefits,” such as emergencies, mental health care, maternity care and prescription drugs. They’re also subsidized for people who earn less than four times the poverty level, or an income of $103,000 for a family of four. At the lower-income levels, down to the poverty level, the subsidies can be so significant they can even make a plan free.
People from zero income to the poverty level are not eligible for subsidies. Those people and the upper-income people on the ACA market must pay full price for their plans, a huge cost these days. Many simply don’t buy.
But many do. More than 400,000 Georgians currently have Obamacare plans.
There are reasons the market might do well this year.
Above all, say experts and insurance companies, the market is finally looking stable. For the past year the news hasn’t been dominated by fights about repealing the health care law that make consumers wary. That was such a big issue last year, according to one study, that large portions of Americans believed Obamacare had been repealed and that no one could sign up.
Nowhere is that stability so apparent as in Georgia. In this state during the 2018 plan year, insurance companies cited uncertainty over the political fights as one reason to raise rates as much as 57.7%. This year, rates stayed flat and some even went down.
Two new insurers also entered the market in Georgia, Oscar Health and CareSource. That means more competition for the four companies that were already here: Ambetter, Anthem/Blue Cross, Centene/Ambetter and Kaiser Permanente. And it means more options for some Georgians.
U.S. Health and Human Services Secretary Alex Azar in a phone call with reporters had a different explanation for the market’s stability than the toning down of repeal rhetoric. He said President Donald Trump was apparently better at running the exchange than President Barack Obama.
It's an open question how long the exchange will continue to exist at all. Conservative state attorneys general, including Georgia's Chris Carr, have sued to repeal the entire ACA health law, and their suit is getting a serious hearing from federal judges. In addition, Gov. Brian Kemp has proposed a set of "waiver" proposals asking the federal government to allow him to make big changes to the marketplace.
In the meantime, here is some information on signing up.
- Open enrollment is the only time each year when people can sign up for Obamacare plans. The enrollment period lasts six weeks. You sign up in the fall and the plans start Jan. 1. It's possible to buy a plan now or browse, seeing on healthcare.gov what type of plan is available under a family's circumstances and how much it would cost, given discounts for some incomes and the number of people in the household.
- Open enrollment on the ACA exchange runs from Nov. 1 through Dec. 15.
- People can start with the federal ACA sign-up website, healthcare.gov.
- Beware of some of the websites that come up on an internet search for "Obamacare" or "ACA." They may dupe people into thinking they're the real Obamacare or ACA website. If going outside healthcare.gov, it's important to deal with an honest site, agent or navigator to get the best plan. Unscrupulous sites might promote alternative plans that receive a higher commission for the website or insurance agent, but can be more expensive for the client or deliver less protection than they thought. It's healthcare.gov where the government is calculating what you really pay — including the all-important discount most applicants receive after federal help.
- Healthcare.gov also has a phone number with helpers, 1-800-318-2596. For Spanish speakers, the website is cuidadodesalud.gov.
- Georgia has a designated navigator organization, which received a $500,000 federal grant to help people sign up. This year it's the Georgia Primary Care Association, which represents clinics across the state. That puts them in a good position to reach a broad swath of people. Federal navigator funding no longer includes funds for much advertising. The association does outreach at places such as large flea markets and rodeos, and it has navigators at several of the state's federally qualified health centers (FQHC's). There's a phone number to talk to a navigator, too: 1-844-442-7421.
- HealthSherpa.com, the only web broker that sticks to ACA-compliant full-coverage plans, has a good reputation for the ease of signing up. It taps into the federal data on healthcare.gov and presents it in an easier format.
- A large organization that used to be a federal navigator for Georgia, Insure Georgia, is still doing that work but as a charity organization now, a nonprofit insurance agency. It has a website with additional information, InsureGa.org, and helpers at its phone number, 1-866-988-8246.
- Private insurance agents who are reputable and have experience in health insurance can also be a resource for these plans. A list of them for your geographical area can be found on healthcare.gov.