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By population, Georgia is the ninth largest state in the U.S.1 Approximately 12percent of its 10.3 million residents are uninsured—a tie for the nation’s third-highest uninsured population with Arizona, Florida, Mississippi and Utah.2 This rate has improved from 22 percent in 2014, the first year the Affordable Care Act’s individual mandate took effect.3
Will rising individual health insurance premiums make coverage unaffordable to Georgians and reverse this improvement? Georgia insurance officials in September 2017 approved average rateincreases of more than 50 percent for 2018 Obamacare plans.4 As in other markets, political uncertainty, especially around cost-sharing reduction payments(CSR), has been cited as the reason for relatively significant premium hikes.5 The Trump administration announced on Oct. 12, 2017, that it would stop paying insurers federal funds for this subsidy, which helps eligible individuals and families reduce out-of-pocket healthcare expenses.6 When filing 2018 rates Georgia insurers proactively requested rate increases in anticipation this might occur.
Georgia residents do have several options when it comes to selecting healthcare benefits. Individual major medical insurance, employer-based major medical coverage, Medicare and Medicaid qualify as ACA-compliant plans. Georgians may also purchase supplemental, dental and temporary policies that can help lower their out-of-pocket healthcare spending, whether or not they have an Obamacare plan.
If you live in Georgia, you can purchase additional health benefits to help with dental and medical expenses—expected and unexpected, large and small—throughout the year. You can buy these plans whether or not you have ACA-compliant coverage. Plus, there’s no open enrollment period for these products, which means you can apply any time and not just during ACA open or special enrollment periods.
Have a long-term plan for the unexpected. Hospital, surgical and critical illness benefits.
Subsidy-eligible ACA plans for premium and out-of-pocket relief
Individual and family health insurance plans are available to Georgia residents through HealthCare.gov, which is the federal Obamacare exchange. Those who live in Georgia can also buy ACA plans in the private health insurance market from a health insurance producer or company.
ACA exchange name: HealthCare.gov
Type: Federally facilitated
Average 2017 benchmark planpremium(before tax credit subsidy): $2867
Average 2017 benchmark plan premium (after tax credit subsidy): $2078
Average 2017 rate change: 15 percent9
Unofficial average 2018 rate change: Georgia insurers received approval for an average rate increase of 50 percent in 2018.10
Georgia's on-and off-marketplace individual health insurance plans
The following health insurance carriers filed 2018 rates for individual plans in Georgia11:
GA health insurance options beyond ACA exchanges
Georgia residents who do not qualify for Obamacare subsidies or prefer to shop away from the ACA exchanges may do so. The off-exchange market may include additional major medical plan options.
If the lowest-cost bronze Obamacare plan available to you costs more than 8.16 percent ofyour household income, including any premium tax credit subsidy you receive, you may qualify for an affordability exemption.12In this circumstance, if your exemption application is approved, you would not be required to have an ACA-compliant health insurance plan and could look for affordable alternatives to help you pay for healthcare expenses. Such options may include short term medical insurance, supplemental benefits, hospital plans, or a medical bundle.
Paying for healthcare deductibles and medical bills
Ultimately, the best insurance benefits are those that work with yourhealthcareand budgetary needs. Minnesotans can follow these steps to help keep their monthly plan premiums, annual deductible amount and medical bills as low and manageable as possible.
Do you need major medical coverage, supplemental benefits or both? Are you looking for a temporary plan while in between ACA-compliant coverage?
Do you have preexisting conditions? Do you qualify for income-based premium tax credits from an ACA exchange?
Do you want to keep monthly premiums as low as possible and use additional benefits to manage a high deductible?Are you self-employed? What can you afford to spend?
Once you have an idea of what products interest you and meet your needs, it’s time to find out what coverage will cost you. Compare plan premiums and benefits to find your match.
1United States Census Bureau. “Annual Estimates of the Resident Population for the United States, Regions, States and Puerto Rico: April 1, 2010 to July 1, 2016.” https://www.census.gov/data/tables/2016/demo/popest/state-total.html
2The Henry J. Kaiser Family Foundation. “Health Insurance Coverage of the Total Population. Timeframe: 2015.” http://www.kff.org/state-category/health-coverage-uninsured/
3The Henry J. Kaiser Family Foundation. “The Georgia Health Care Landscape.” Sept. 20, 2014. https://www.kff.org/health-reform/fact-sheet/the-georgia-health-care-landscape
4Miller, Andy. “Insurance Premiums on Georgia’s Obamacare Exchange Could Go Up an Average 50%.” Georgia Health News. Sept. 28, 2017. http://www.macon.com/news/local/article175842756.html
6 Mathews, Anna Wilde. "Health Insurers Face Big Financial Hit After Trump Move to End ACA Subsidies." The Wall Street Journal. Oct. 13, 2017. https://www.wsj.com/articles/health-insurers-face-big-financial-hit-after-trump-move-to-end-aca-subsidies-1507902956
7 Cox, Cynthia, et al. “2017 Premium Changes and Insurer Participation in the Affordable Care Act’s Health Insurance Marketplaces. Table 1: Monthly Silver Premiums and Financial Assistance for a 40 Year Old Non-Smoker Making $30,000/Year.” The Henry J. Kaiser Family Foundation. Last updated Nov. 1, 2016. https://www.kff.org/health-reform/issue-brief/2017-premium-changes-and-insurer-participation-in-the-affordable-care-acts-health-insurance-marketplaces
9Herron, Janna. “Here’s How Much Obamacare Premiums are Rising in All 50 States.” The Fiscal Times. Nov. 1, 2016. http://www.thefiscaltimes.com/2016/11/01/Here-s-How-Much-Obamacare-Premiums-Are-Rising-All-50-States
10Miller, Andy. “Insurance Premiums on Georgia’s Obamacare Exchange Could Go Up an Average 50%.” Georgia Health News. Sept. 28, 2017. http://www.macon.com/news/local/article175842756.html
12HealthCare.gov. “How to Claim an Exemption Because 2017 Marketplace Health Coverage Is Considered Unaffordable Based on Your Projected Annual Household Income.” Accessed Sept. 13, 2017.https://www.healthcare.gov/exemptions-tool/#/results/2017/details/marketplace-affordability