Health Reform

Georgia insurers received more than 220,000 applications for health coverage in the Affordable Care Act’s exchange as of the official federal deadline of March 31, state officials said Wednesday.

Ralph Hudgens

Insurance Commissioner Ralph Hudgens, though, said premiums have been received for only 107,581 of those policies, which cover 149,465 people.

“Many Georgians completed the application process by the deadline, but have yet to pay for the coverage,” Hudgens said in a statement Wednesday.

March 31 was the official deadline for individuals to get insurance coverage or face a financial penalty under the ACA. Yet because of the deluge of last-minute shoppers, federal officials relaxed the rules for those who reported having trouble with the exchange, and gave them into this week to sign up.

Given that extra time, there have presumably been more Georgians both signing up and paying for their premiums in April. They would not be included in the figures released Wednesday. full story

Annie Jones says she works hard and tries to keep fit, but she has high blood pressure, a condition that doctors have told her she inherited from her father.

The Sparta resident, who turned 60 this year, is worried about health care. Jones won’t reach Medicare age for another five years. She earns $10,000 a year as a part-time home health care worker and can’t afford her blood pressure medicine as well as the regular monitoring she needs.

Jeanna Buckler of Kentucky has qualified for Medicaid under expansion.

Jones is one of up to 600,000 Georgians defined as the working poor  – those adults who earn less than 100 percent of the federal poverty level (FPL). (In 2014, that’s $11,670 for an individual and $23,850 for adults in a family of four.)

For the first time ever in Georgia, these adults would be eligible for Medicaid if the state expanded the program as authorized by the federal Affordable Care Act (ACA), also known as Obamacare.

The ACA originally made Medicaid expansion virtually mandatory for states. But the U.S. Supreme Court, while upholding the ACA in general, ruled that expansion must be optional. That made things complicated, because some other provisions of the law presupposed that Medicaid would be expanded.

Now the issue of expansion is being hashed out in the individual states.

In Georgia, Gov. Nathan Deal refuses to expand Medicaid, saying the state cannot afford it. The Republican-controlled General Assembly agrees with Deal and has even gone a step further. It passed legislation during the 2014 session that requires the Legislature, not just the governor, to approve any Medicaid expansion.

“They’re telling me I don’t deserve it,” Jones said of Medicaid. “When they say Georgia is just fine without expanding Medicaid, well, it’s just fine for them. I need some type of help. I can’t get it anywhere. It’s very stressful.”

If Jones made more than $11,670, she would be eligible for federal subsidies to buy private insurance through Georgia’s health care exchange, which is operated by the federal government as part of the ACA.

“I didn’t get enough money working part time, making minimum wage,” Jones said. She assists two home health care clients for 22 hours a week and is trying to get more work. “A lot of people are just like me, trying to make it. Where do you go?” full story

Like many other last-minute shoppers, radio talk show host Sidney Wood sought to sign up for insurance coverage Monday just before a midnight deadline.

Wood, of WAOK in Atlanta, originally signed up for an Affordable Care Act health plan in December, but he didn’t pay the premiums and wound up without a policy.

Sidney Wood meets with navigator Amanda Ptashkin

At a Monday event sponsored by World Changers Church International in College Park, Wood got help enrolling from Amanda Ptashkin. She’s a health insurance navigator, a specially trained guide for people using the health care exchange.

“I’m a cancer survivor,’’ said Wood, 48, adding that he has been uninsured for a couple of years.

Unfortunately, he didn’t find everything running smoothly on deadline day. Even with the expert help of Ptashkin, Wood was among legions of people across America who had difficulty making headway on healthcare.gov. full story

John Boyle, a 63-year-old Athens guitarist, has never bought health insurance. He credits good genes and good luck with keeping him healthy enough not to need it.

But now, a couple of years before he becomes eligible for Medicare, he is looking for a little extra health security.

“As I get older, I hope I can stay healthy,” he said. “It is a concern.”

Last year, a program designed with people like Boyle in mind was in the works in the Athens area. But now the organizers have put the plan on hold because they’re worried that it could actually discourage people from obtaining insurance under the Affordable Care Act.

(The ACA enrollment deadline for 2014 is Monday. That remains in effect, though the government said last week that people who have attempted the enrollment process and not been able to complete it will be allowed extra time, till about mid-April.)

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As a retired health care executive and former state employee, I appreciated the GHN interview with Gov. Nathan Deal. So much so that I would like to comment on a few of the remarks he made.

Jack Bernard

He indicates that Medicaid expansion would add 620,000 people to our Medicaid rolls, implying it would clearly be a disaster for the state. Georgia’s uninsured rate, by the way, has been estimated at up to 22 percent, one of the highest in America.

The figures Deal cites regarding the cost of expansion are skewed. Expansion will create 70,000 jobs (mostly private sector). Deal fails to mention the objective Georgia State University study that made this projection. He further ignores the taxes that will be collected by the state, cities and counties as a result of this increased economic activity.

In fact, the Georgia Budget and Planning Institute has stated that, when these factors are taken into account, the net cost of expansion would be only $25 million a year, a very small amount when considering Georgia’s multibillion-dollar state budget. full story