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Obamacare Georgia

Updated May 21, 2018

Get Actual Updated Price Estimates For 2018 Georgia Obamacare Plans

Georgia does not run its own state-based health insurance exchange. Instead, residents here use the federally facilitated site at HealthCare.gov. They can also speak to an independent health insurance agent over the phone or use an independent marketplace to shop and research plans and a web-based online broker website to enroll directly while still taking advantage of cost-saving measures under the Affordable Care Act (Obamacare).

Requirement by Law

Despite the political upheaval the past couple of years over healthcare reform, it’s important to note that Obamacare’s individual mandate is still technically in effect. The IRS has stated that it will be enforcing the mandate as well. Under the Affordable Care Act, all eligible Americans – which represents much of the country – must hold qualifying health insurance or face a penalty fee. For this year, the fee is the greater of 2.5 percent of your household’s taxable income or a flat fee of $695 per adult ($347.50 per child under 18). The fee increases with inflation each year.

In late 2017, Congress passed a tax bill that included a provision that would get rid of the individual mandate in 2019, which means that anyone who goes without qualifying health insurance in 2019 will not face a penalty when they file their 2019 tax returns. Unfortunately, this may also mean that many Georgians are less compelled to get a health insurance plan. This is the fear in many states in fact.

Enrollment in Georgia

During the 2017 open enrollment period, 493,880 people signed up for health insurance using the exchange, compared to nearly 588,000 in 2016, which represents a 16 percent decrease. The state saw a much smaller decrease in enrollments from 2017 to 2018 however with nearly 481,000 Georgians enrolling in a subsidized plan during the 2018 open enrollment period, which represents only a 2 percent decrease from the year prior. The decrease in enrollment numbers the past couple of years can be contributed to several factors, including uncertainty over the current administration’s stance on healthcare reform, rising premium costs, fewer carrier and plan options and Congress' efforts to repeal and replace Obamacare with some other alternative plan.

While Georgia customers can go straight to the HealthCare.gov website for coverage, it may be beneficial to shop around using a comparison site like this one. Getting current quotes from multiple carriers can help you find a plan that adequately addresses your needs and fits your budget. Brokers can also help explain your options more clearly.

In 2018, Georgia customers were able to choose from four carriers on the exchange, which is one fewer than the 2017 open enrollment period.

  • Alliant
  • Ambetter from Peach State Health Plan (owned by Centene)
  • Anthem Blue Cross Blue Shield of Georgia
  • Kaiser

Although there were four total carriers offering coverage across the states, most residents in Georgia actually had only one carrier option in 2018, but in 14 counties customers had two carrier options. Blue Cross Blue Shield of Georgia, owned by Anthem, will offer coverage in 96 of the state’s 159 counties. Premium rates increased by an average of about 29 percent assuming cost-sharing reduction payments are guaranteed for next year.

Participation commitments, plan information and premium rates are not due until later in the summer/early fall of 2018 so it's unknown at this time how many carrier options Georgians will have next year.

Cost Assistance

For families and individuals that earn between 100 and 400 percent of the federal poverty level - $12,060 to $48,240 for a single person in Georgia - there are provisions in place for financial assistance, including tax credits and subsidies. These subsidies are very important to people who want access to better health  insurance plans, but couldn't afford the premium prices if it wasn't for the financial help offered under the Affordable Care Act (Obamacare). Approximately 87 percent of customers in Georgia qualified for premium subsidies in 2017.

If you need to enroll in a health insurance plan outside of the open enrollment period (the 2018 open enrollment period ended on December 15th) you can do so if you have a qualifying life event like you got married or divorced, you had a child, you lost your coverage from your employer or you moved to a new state and need new coverage. You can also get subsidized help to pay your Obamacare premiums if you qualify for special enrollment period due to your qualifying life event.

In 2017, CMS passed a rule that tightened the restrictions for enrolling in an Obamacare plan outside of the open enrollment period. One of the rules that were passed prohibited people from having a qualifying life event if they lost coverage due to non payment of their premium plan. Another rule required consumers to provide documented proof of their qualifying life event.

The state of Georgia currently does not have a state-run health exchange, where you can get quotes directly. Instead, the federal health exchange will direct you to a number of approved insurance brokers and exchanges. Some of these are privately owned. Others will direct you to publicly held, for-profit companies.

As a basis for comparison, we encourage you to get quotes from other insurance coverage providers. Specifically, you should have health insurance quotes from current providers, as a base for comparison against the federal health exchange-approved providers. This will provide you with a better range of plans, pricing information and overall access to affordable healthcare benefits.

Obamacare in Georgia

The Patient Protection and Affordable Care Act, also known as the ACA, or Obamacare, required everyone to have health insurance in 2015. All individuals that were not insured in 2014 had to pay a tax penalty.

The premise behind the ACA is that everyone deserves access to quality healthcare. To ensure that some of the poorest families are able to afford insurance, Obamacare does have a Medicaid expansion provision. Under this provision, the government covers the majority of the costs for qualifying families that are covered by Medicaid.

At first, this provision was to be federally mandated, requiring all states to participate. The Supreme Court later struck down the mandate in its ruling concerning the Affordable Care Act. Now, states have the option of whether to expand their Medicaid program. Georgia is one of those states that have chosen not to do so. Governor Nathan Deal (R) made it clear that he was not in support of Medicaid Expansion in the state.

The majority of working Americans, however, have health insurance provided by their employer. Employer-provided health insurance does satisfy the requirement set forth by Obamacare. For those, however, that do not have such insurance, they may shop on private or the federal marketplace.

Under the Affordable Care Act, there is a federal exchange that has been set up. The individual states also had the option to set up their own exchange. Like some of the other states, Georgia opted not to create a state health exchange. As such, Georgia residents have to shop for health insurance from the federal exchange. The exchange is not insurance. It only provides the options for different insurance providers and plans.

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