“It’s really the premiums that drive this,” Custer said. “So it looks like having the stable premiums and more companies in the market is really having an effect.”
Many factors play in to whether people sign up for ACA insurance. Some good factors may drive down ACA sign-ups, such as more people getting job-sponsored insurance. The ACA only sells individual plans.
Other, negative, factors may drive down sign-ups, such as declining resources for enrollment help and publicity, and rhetoric criticizing the ACA. Studies showed that after Republicans spent 2017 trying to repeal the ACA, nearly one-third of Americans either thought it had actually been eliminated or were unsure.
But the market is better established now that there’s been no attempt to repeal the ACA this year. In addition, the big thing in Georgia is prices. Most Georgia companies’ premium changes were in the single digits, except for Alliant, whose average premium price fell 10.2%.
That's a big change from previous years. One year alone the big insurer Blue Cross, now known as Anthem, increased rates 57.5%.
Most people on the exchange don’t pay those steep prices, but instead benefit from subsidies that drive the prices down to affordable levels. For the 10% that do pay full price and those who pay near full price, the burden has grown massive.
Sign-up assistance funding has also shifted this year, to an organization that has experience working throughout rural Georgia.
The federal government awarded $550,000 this year and next year to the group of federally funded clinics across the state called the Georgia Association for Primary Health Care.
Enrollment levels matter because Georgia remains the third-least-insured state in the nation. As of the latest data, 19% of working-age adult Georgians were uninsured. Many of those people are in the income bracket that can reap big subsidies, making ACA insurance nearly free or inexpensive.
Popular or not, the future of the ACA is unclear. Georgia is one of several conservative states that are suing to repeal the ACA. In the meantime, both Georgia and federal officials have been pushing forward alternatives to ACA insurance that are cheaper but may not cover as much.
U.S. Secretary of Health and Human Services Alex Azar told reporters in a phone call kicking off enrollment this year that the ACA “is not a workable way for Americans to finance the care they need, and that is why we continue to look for ways to open up new alternatives and replace this broken law.”
In the end, though, Custer cautioned patience in watching the trends. “I know we’re tracking over this point last year exactly,” he said. “But every year is kind of a different experience in terms of when … people sign up. So we’ll just have to wait for the final numbers.”
FAQ: ACA OPEN ENROLLMENT
Open enrollment on the Affordable Care Act exchange market runs from Nov. 1 through Dec. 15.
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.
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 $550,000 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, 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.
THE NUMBERS SO FAR
Open enrollment on the ACA exchange ends Dec. 15. This is the federal snapshot for week four of 2018 compared with week four of 2019. 2019’s contains one less day.
Total sign-ups so far in Georgia:
2018 (Nov. 1-24): 139,645
2019 (Nov. 1-23): 145,968
Daily average so far:
Affordable Care Act sign-ups so far, in week four of 2018 compared with week four of 2019. The period for 2019 contains one less day than 2018.
Total nationwide by week four:
2018 (Nov. 1-24): 2,424,913
2019 (Nov. 1-23): 2,372,957
Daily average so far:
2018 (Nov. 1-24): 101,038
2019 (Nov. 1-23): 103,172