Census: Fewer Georgians lack health insurance, but state still lags

The percentage of people in Georgia who lack health insurance fell in 2014, mirroring a national trend linked to new coverage from the Affordable Care Act, the U.S. Census Bureau reported Wednesday.

But Georgia’s percentage of people without coverage last year was the fourth-highest in the nation, trailing only Texas, Alaska and Florida.

Georgia’s 3-point drop to 15.8 percent from 18.8 percent was expected, said Bill Custer, a health insurance expert at Georgia State University. He cited the coverage newly available through the ACA, commonly called Obamacare, and an improved state economy. But “Georgia is clearly lagging behind other states,” he said.

Nationally, the percentage of people without health insurance in 2014 was 10.4 percent, or 33 million, a big decline from the year before, when 41.8 million, or 13.3 percent, had no coverage, the Census Bureau reported.

Coverage gap

Between 2008 and 2013, the national uninsured rate remained fairly stable, the report stated. The biggest changes last year came from those directly purchasing insurance and from an increase in Medicaid enrollment, according to the report, considered the most consistent and complete picture of the nation’s health coverage.

The uninsured rate was higher in states that did not expand their Medicaid programs under the ACA, the Census Bureau noted. More than half of the states have expanded Medicaid, making more low-income adults eligible for the program. But Georgia, along with most Southern states, has declined to do so, with political leaders citing the cost of such a move.

Georgia Medicaid provides health coverage to roughly 1.8 million mostly poor children, pregnant women, seniors and people with disabilities. Expansion would add about 600,000 people to the Medicaid rolls, mostly low-income adults without children.

Meanwhile, an estimated 300,000 people fall into a so-called “coverage gap” in which they make too much money to qualify for Medicaid but not enough to qualify for federal tax credits to buy on the Affordable Care Act marketplace.

Safety-net providers

The ACA was fully implemented in 2014 with the debut of the online insurance exchange, and Georgia’s sign-ups in that new marketplace surpassed 310,000. Also, the state’s Medicaid and PeachCare membership last year increased by tens of thousands, as more outreach sparked by the ACA prompted individuals already eligible but not enrolled to join the two government programs.

But despite the overall decline in rates of uninsured people, some safety-net providers in Georgia said Wednesday that they have not seen a drop in demand for medical care from uninsured patients over the past two years.

Cathryn Marchman of Mercy Care, a federally qualified health center serving Atlanta’s poor, said its percentage of patients without coverage has not changed. It remains more than 90 percent.

Statewide, Georgia’s 34 federally qualified health centers, which have 197 clinic sites across the state, saw an increase in the number of uninsured patients served last year.

Self-pay patients

Overall demand for services by all patients is greater, added Duane Kavka of the Georgia Association for Primary Health Care. And Grady Health System, which operates Atlanta’s biggest safety-net hospital, Grady Memorial, said its percentage of “self-pay” patients has remained steady at 30 percent over the past three years.

Yet Jimmy Lewis, CEO of HomeTown Health, an association of rural hospitals in Georgia, said Wednesday that his membership has seen a slight uptick in insured patients, thanks to an increase in employment and more coverage through the insurance exchange.

Custer of Georgia State said Medicaid expansion would reduce the state’s number of uninsured people significantly. He noted that California, which has expanded Medicaid, saw its rate of those without coverage shrink considerably. It’s now at 12.4 percent. “For decades, California had one of the largest uninsured populations,” Custer said.

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This article was done in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. Andy Miller is CEO and editor of Georgia Health News.Atlanta Journal-Constitution staff writer Misty Williams contributed to this article.