Open enrollment for 2020 plans on the insurance exchange for Obamacare, also known as the Affordable Care Act, closes Dec. 15. (PHOTO via screenshot of Healthcare.gov)
Photo: Hart, Ariel (CMG-Atlanta)
Photo: Hart, Ariel (CMG-Atlanta)

Stability on Georgia Obamacare market yields more sign-ups for 2020

The pace of Obamacare enrollment this year is up 9% so far in Georgia, a turnaround from declines since the beginning of the Trump administration. Nationwide, the pace of enrollment is up 2%.

The open enrollment period still has a couple of weeks to go, and the numbers don’t mean a lot until the final tally is in. But for some analysts, the news is what they expected for health insurance sign-ups on the Affordable Care Act exchange market, also known as Obamacare.

“With the stability of the market and the lack of a lot of bad rhetoric about it, I expected it to be a bit higher,” said Bill Custer, a professor of health economics at Georgia State University. “And that’s what happened.”

There’s no data yet to say why. But there’s an obvious suspect: stability.

After years of steep hikes, premiums in Georgia are finally stable or even declining. In addition, two new companies have joined the Georgia market.

“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.”

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