ABOUT THE HEALTH INSURANCE EXCHANGE
What it is: Created by the Affordable Care Act, the health insurance exchange is an online marketplace where consumers will be able to compare health plans offered by private insurance companies, figure out whether they’re eligible for government health programs and determine whether they qualify for federal financial help to buy coverage.
Who it’s for: For the most part, the exchange will serve people who don’t get affordable coverage through their jobs, such as the unemployed, self-employed and students. Nearly 900,000 Georgians are expected to shop on the exchange.
Participating insurers: Seven insurance companies have submitted dozens of health plans to sell on the exchange. They are Blue Cross and Blue Shield of Georgia, Peach State, Aetna, Kaiser, Coventry, Alliant and Humana.
When it opens: Consumers will be able to start buying health plans on the exchange on Oct. 1 with coverage taking effect Jan. 1.
How to learn more: Georgia’s exchange isn’t open yet, but consumers can start learning about their options by visiting HealthCare.gov or calling a customer service representative at 800-318-2596.
The Atlanta Journal-Constitution is covering every development as the Affordable Care Act rolls out in Georgia, with news reports like this one and longer-view articles that analyze the law’s impact on the people of our state. We will continue to offer most comprehensive and reliable coverage in Georgia as important deadlines approach, such as the opening of the insurance exchange on Oct. 1.
Georgia Insurance Commissioner Ralph Hudgens has filed an “emergency request” with the Obama administration to delay approval of rates for individual health plans that he said will cost some consumers more than double what they are paying today.
“In complete contradiction to every promise made by the President with regard to the Patient Protection and Affordable Care Act, insurance companies in Georgia have filed rate plans increasing health insurance rates up to 198 percent for some individuals,” Hudgens said in a letter to Health and Human Services Secretary Kathleen Sebelius. He sent the letter Monday and released it publicly on Tuesday.
The state must approve or deny dozens of health plans to be sold on a new federally run insurance website, called an exchange, that is critical to the Affordable Care Act’s goal of insuring millions of Americans. The deadline to approve plans is Wednesday, but Hudgens is asking for a 30-day extension.
“I want to protect the consumers of the state of Georgia but when these things are going up, these prices are going up, I don’t want people to blame me,” Hudgens told the AJC. “I’m going to be up for re-election come 2014.”
Bill Custer, a Georgia State University health care expert who has reviewed the filings, said a 198 percent increase is nowhere near typical.
“The majority of Georgians with individual coverage will not see rate increases anywhere near that amount and many will see rate decreases,” Custer said.
The U.S. Health and Human Services Department is reviewing Georgia’s request, a spokeswoman said Tuesday.
“We are working closely with states to help them meet all deadlines and ensure that the marketplaces are ready for consumers to begin shopping on Oct. 1.,” she said in a statement.
Outside actuaries have reviewed the plans and rates filed in Georgia by the seven companies seeking to sell insurance on the exchange and found six of them to be appropriately priced. Hudgens would not identify the seventh company. Even so, Hudgens said that before he approves the rates he wants Sebelius to assess whether the prices are appropriate.
“I am really waiting for her to come back and tell me whether she thinks they are excessive,” said Hudgens, in an interview with The Atlanta Journal-Constitution.
Hudgens acknowledged that the 198 percent increase mentioned in his letter was an extreme example that applied to only one type of consumer and under rates proposed by one company. He said consumers in their 20s who buy their own plans are likely to see increases of about 100 percent, while older consumers who buy their own plans will be charged 20 to 40 percent more.
Insurance experts, however, say it’s misleading to do a straight comparison of individual rates now vs. individual rates on the exchange.
Starting Jan. 1, the health law will require insurers to sell to anyone regardless of how healthy they are. The law also restricts how much more insurance companies can charge older adults than their younger counterparts, puts a limit on out-of-pocket costs for consumers and requires insurers to offer certain essential benefits, such as free preventive care.
Depending on their income, consumers may also qualify for federal assistance to help pay for their insurance if they aren’t offered an affordable plan at work.
Rates can vary dramatically within states; for example, rates in South Georgia will be substantially higher than those in metro Atlanta.
In addition, some states have rejected insurers’ proposals and cut rates substantially, said Gary Claxton, a vice president at the nonproft Kaiser Family Foundation. Others, he said, “seem to be accepting what’s being asked for.”
Claxton added that while younger, healthier consumers will likely pay higher premiums under the law, those under 30 who can’t find affordable coverage will be able to buy more basic catastrophic coverage that is targeted at young people and is a lot cheaper.
State Sen. Vincent Fort (D-Atlanta) said Hudgens was simply playing politics with his request.
“He doesn’t need Sebelius to give him a 30-day extension, or whatever he has asked for, in order to make a decision about whether these rate increases are justified or not,” Fort said. “I think he’s just looking for political cover in order to not take responsibility for what he wants to do.”
Fort said Hudgens should focus more on the nearly 2 million people in Georgia who currently lack insurance coverage.,
“I think Ralph Hudgens’ time would be better spent urging the governor to expand Medicaid, which would bring hundreds of thousands of Georgians into health care, as opposed to playing these kinds of political games.”
The Affordable Care Act called for a dramatic expansion of Medicaid to all low-income Americans. But the U.S. Supreme Court ruled that the federal government may not compel the states to expand Medicaid, even if the feds paid for the expansion, and Gov. Nathan Deal has decided against it. As a result, hundreds of thousands of Georgians will remain uninsured.
Meanwhile, nearly 900,000 Georgians are expected to shop on the insurance exchange. The online marketplace will mostly cater to people who don’t get health coverage through work, such as the unemployed, the self-employed and students.
While Fort criticized Hudgens’ action, state Sen. David Shafer (R-Duluth) issued a press release applauding Hudgens’ request to delay approval.
“I have always suspected that Obamacare would lead to higher health insurance rates,” Shafer said in a statement. “But the rate increases pending before the Georgia Insurance Department are absolutely staggering in magnitude.”
Republican leaders in other states have voiced similar concerns.
Earlier this month, Indiana officials said individual insurance rates will climb by an average of 72 percent next year as a result of the health law.
“The Affordable Care Act requires many Hoosiers to purchase more comprehensive and more expensive health insurance than they may want or need,” Chief Deputy Insurance Commissioner Logan Harrison said in a statement. Indiana Democrats disputed the claim.
The average cost of individual coverage in Ohio will increase from $223 to $420 next year – an 88 percent jump, officials have said.
In New York, the average rate for individual insurance is expected to fall by half. Experts say, however, most states won’t see such dramatic declines. That’s because New York law already contains some of the key provisions of the Affordable Care Act.
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