Georgia saw one of the biggest drops in Obamacare sign ups nationwide with nearly 94,000 fewer people enrolling in health coverage this year compared with 2016.
That's a 16 percent decline — the fourth biggest drop among states that use the federal health insurance exchange Healthcare.gov, new federal data shows.
The enrollment slump was likely spurred, in part, by continued uncertainty about the future of the Affordable Care Act and a decision by the Trump administration to pull advertising for the exchange website in the days leading up to the end of open enrollment when there is typically a surge in sign ups as people rush to meet the deadline.
Some parts of Georgia, especially in rural areas, also saw steep increases in insurance premiums where there’s little competition among insurers.
"Georgians aren't enrolling in Obamacare because it's collapsing under its own weight, in fact, there is currently only one health care provider in 96 out of 159 counties,” said Caroline Vanvick, a spokeswoman for U.S. Sen. David Perdue.
The law’s tax credits protect a lot of people from those higher rates, but for those who don’t get that benefit, “that increase is a big deal,” said Bill Custer, a health care expert at Georgia State University.
Roughly 9.2 million Americans signed up for 2017 coverage, a 4 percent drop from last year, according to the Department of Health and Human Services. The numbers don’t include enrollment in states that run their own insurance exchanges, such as California.
Louisiana had the biggest drop (33 percent), though that decline may have been fueled in large part because the state recently expanded its Medicaid program for the poor.
The drop in coverage comes after the Trump administration pulled advertising to promote HealthCare.gov just days before open enrollment ended Jan. 31.
The cut back in advertising may have had a more severe impact here than in some other states because Georgia has fewer health insurance navigators and other guides who walk people through the sign up process, Custer said.
Consumer advocates decried the move saying it would cause some people who could have signed up for coverage to remain uninsured.
“There is no doubt that enrollment would have been even higher if not for the uncertainty caused by political attacks on the law, and the Trump Administration’s decision not to provide consumers with all of the resources and support available to help them enroll,” Anne Filipic, president of consumer advocacy group Enroll America, said in a statement.
"The federal government has spent more than $60 million promoting the open enrollment period," the spokesman told Politico. "HHS has pulled back roughly $5 million of the final placement in an effort to look for efficiencies, where they exist."
Uncertainty about the future of Barack Obama’s signature law likely also played a role in lackluster enrollment.
The GOP’s calls to rapidly repeal the health care law — without a replacement plan at the ready — have raised concerns over the stability of the Obamacare insurance exchanges going forward.
Experts warn repealing Obamacare without a replacement ready to go could devastate the country’s individual insurance market. Such a scenario could lead to 18 million Americans losing their insurance in the first year alone — growing to 32 million within a decade, a recent report by the Congressional Budget Office showed.
“We’ve heard ‘repeal and delay.’ We’ve heard ‘repeal and replace.’ We’ve heard ‘repair,’” from politicians in Washington D.C., said Cindy Zeldin, executive director of consumer group Georgians for a Healthy Future. “(That) lack of clarity is not good for consumers. They don’t know what the future is going to bring.”
It seems that there is an “unnecessary sabotage” to destabilize something that is working, Zeldin said. Are there improvements that could be made to the health law? Sure, Zeldin said. High deductibles, narrow networks of doctors and other issues are concerns, but those can be fixed within the law’s current framework, she said.
Republicans argue, however, that the law is fundamentally flawed.
"Georgians aren't enrolling in Obamacare because it's collapsing under its own weight. In fact, there is currently only one health care provider in 96 out of 159 counties," said Caroline Vanvick, a spokeswoman for U.S. Sen. David Perdue.
The GOP — once keen on gutting Obamacare as quickly as possible — has yet to agree on any replacement plan. Indeed, lawmakers have increasingly seemed to recognize repealing and replacing the sweeping law could take not weeks but months or even longer.
Republican U.S. Sen. Johnny Isakson supports killing the health law but said in an interview with The Atlanta Journal-Constitution last month that "repealing it without a replacement is an unacceptable solution."
President Donald Trump on Sunday, in a pre-Super Bowl interview with Fox News host Bill O’Reilly, seemed to reflect the idea that replacing the law could be a long process.
“Maybe it’ll take until sometime into next year, but we are certainly in the process,” Trump said. “Very complicated. Obamacare is a disaster.”
Trump’s comments offer at least some assurance to insurers concerned about the stability of the insurance exchanges, said Custer with Georgia State.
“Things aren’t going to radically change,” at least not in 2018, he said.
There is some urgency for the administration or Congress to make at least temporary decisions to alleviate insurers concerns for next year, Custer said.
Insurance companies must begin deciding by this spring and summer whether they plan to continue offering coverage in the exchanges.
Some regulatory changes could be made now to help stabilize the market, such as tightening rules on enrollment periods so people can’t wait to buy coverage until they get sick, Custer said.
Still, Custer added, there has to be a broader outline of what America’s health care future will look like.
“Stay tuned,” he said. “Uncertainty is the rule of the day in health policy for sure.”
Staff writer Ariel Hart contributed to this story.
These 5 states saw the biggest percentage drops in Obamacare sign ups